Active NPI
Samantha Koranda, PHARMD
- Pharmacist
- Davenport, IA
National Provider Identifier
1083236954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23362
- Practice address
- 1805 Brady St
Davenport, IA 52803-4729 - Phone
- (563) 322-5933
- NPI assigned
- May 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23362 | IA | Primary |
Addresses
Primary practice location
1805 Brady St
Davenport, IA 52803-4729
Mailing address
1805 Brady St
Davenport, IA 52803-4729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23362 | IA | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1805 Brady St
Davenport, IA 52803
Phone (563) 322-5933
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1083236954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 BRADY ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528034729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 BRADY ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528034729",
"telephone_number": "563-322-5933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORANDA",
"first_name": "SAMANTHA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.