Active NPI
Amy Pankow, PHARMD., RPH
- Pharmacist
- Appleton, WI
National Provider Identifier
1285055699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17155-40
- Practice address
- 2101 E Evergreen Dr
Appleton, WI 54913-9001 - Phone
- (920) 733-2305
- NPI assigned
- Jan 2, 2014
- Last updated
- Jan 2, 2014
- 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 | 17155-40 | WI | Primary |
Addresses
Primary practice location
2101 E Evergreen Dr
Appleton, WI 54913-9001
Mailing address
2101 E Evergreen Dr
Appleton, WI 54913-9001
Phone (920) 733-2305
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17155-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1285055699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 E EVERGREEN DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549139001",
"telephone_number": "920-733-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 E EVERGREEN DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549139001",
"telephone_number": "920-733-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANKOW",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "PHARMD., RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-02",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17155-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.