Samantha Wilkes, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.294409 Issued in IL

Practice address

702 W Chestnut St Ste 103
Bloomington, IL 61701-2814

Phone

(309) 807-5160

Fax

(309) 517-0899

NPI assigned

Oct 9, 2020

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 Powell 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

Locations

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.

• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Bloomington, IL
  • NPI 1538648571
  NPD
• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Brockton, MA
  • NPI 1992521512
  NPD (past)

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1295333565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W CHESTNUT ST STE 103",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-807-5160",
            "fax_number": "309-517-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W CHESTNUT ST STE 103",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-807-5160",
            "fax_number": "309-517-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "SAMANTHA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.294409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "POWELL",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah Jean Wieland
• John M. Wieland, M.D.
• Trisha Wierenga, BSN, RN, IBCLC, RLC
• Debbie Novtney Wietfeldt, DNP
• Kelly Rebekah Wilkerson Dullenty, D.C.
• Kristin N Wilkins, APN-CNS
• Melissa Faye Wilkinson
• Don P Willard, MS, PT, ATC
• Alexander Perry Willett, PSYD
• Paul D Willett, PH.D.

• Pharmacist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.