Active NPI
Amanda Lee Cagle, PHARMD
- Pharmacist
- Jersey Shore, PA
National Provider Identifier
1174130843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP452874
- Practice address
- 1321 Allegheny St
Jersey Shore, PA 17740 - Phone
- (570) 398-9861
- NPI assigned
- Sep 28, 2020
- Last updated
- Sep 28, 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 | RP452874 | PA | Primary |
Addresses
Primary practice location
1321 Allegheny St
Jersey Shore, PA 17740
Mailing address
1321 Allegheny St
Jersey Shore, PA 17740
Phone (570) 398-9861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP452874 | Other | PA | PENNSYLVANIA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| RP452874 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Pennsylvania CVS Pharmacy, L.L.C. | Past | Accepting new patients |
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": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1174130843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 ALLEGHENY ST",
"city": "JERSEY SHORE",
"state": "PA",
"postal_code": "17740",
"telephone_number": "570-398-9861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 ALLEGHENY ST",
"city": "JERSEY SHORE",
"state": "PA",
"postal_code": "17740",
"telephone_number": "570-398-9861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAGLE",
"first_name": "AMANDA",
"middle_name": "LEE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-28",
"last_updated": "2020-09-28",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP452874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENNSYLVANIA STATE BOARD OF PHARMACY",
"identifier": "RP452874",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jersey Shore, PA
- Kelly Bay, DC, CNS, CDN, LDN
- Richard A Beatty, DMD
- Hannah Marie Becker, BS, PHARMD
- Kiersten Leigh Betz, RT (R), PA-C
- Catherine A Brosius-Bolick, DO
- Kirkland Campbell
- Nathan James Carpenter, DC
- Citizens Hose Company of Jersey Shore (Jersey Shore Area EMS)
- Leita Faye Clark, COTA/L
- Thomas Carroll Connolly, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.