Samantha Ann Ketterling, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH6046 Issued in ND

Practice address

2475 32ND Ave S Ste 1
Grand Forks, ND 58201-3606

Phone

(701) 775-4209

Fax

(701) 775-9122

NPI assigned

Jul 11, 2018

Last updated

Jul 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Samantha Ann Sorenson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• White Drug Co of Jamestown Inc

  dba Thrifty White Pharmacy #046

  • Community/Retail Pharmacy
  • West Fargo, ND
  • NPI 1033208640
  NPD (past)
• White Drug Co of Jamestown Inc

  dba White Drug #009

  • Community/Retail Pharmacy
  • Grand Forks, ND
  • NPI 1689763294
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1184100398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 55TH AVE S APT 309",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582019271",
            "telephone_number": "218-790-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 32ND AVE S STE 1",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013606",
            "telephone_number": "701-775-4209",
            "fax_number": "701-775-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERLING",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SORENSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marlena Kennedy, ND
• Dana Marie Kennelly, LCSW
• Kevin Keith Kern, PHARM D
• William H Kerzman
• Vanessa Kes, DNP, APRN, WHNP-BC
• Caron Hannah Keys, OTR/L
• Keystone Personal Care LLC
• Christian G Khairallah, MD
• Noreen Khan, MD
• Binod Kharel

• Pharmacist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Pharmacist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.