Active NPI
Amy Crake
- Pharmacist
- Lutz, FL
National Provider Identifier
1275924953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23057
- Practice address
- 1040 Dale Mabry Hwy
Lutz, FL 33548-3004 - Phone
- (813) 435-2934
- NPI assigned
- Feb 17, 2015
- Last updated
- Feb 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 23057 | FL | Primary |
Addresses
Primary practice location
1040 Dale Mabry Hwy
Lutz, FL 33548-3004
Mailing address
5610 Piney Lane Dr
Tampa, FL 33625-4042
Phone (813) 960-2608
Other names 1
- Amy Gardner
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23057 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1275924953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5610 PINEY LANE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336254042",
"telephone_number": "813-960-2608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 DALE MABRY HWY",
"city": "LUTZ",
"state": "FL",
"postal_code": "335483004",
"telephone_number": "813-435-2934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAKE",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-17",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "23057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "GARDNER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.