Active NPI
Amanda Nicole Sharp
- Pharmacist
- Port Orange, FL
National Provider Identifier
1326642463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS52098
- Practice address
- 1816 Dunlawton Ave
Port Orange, FL 32127-2921 - Phone
- (386) 322-3919
- NPI assigned
- Nov 30, 2020
- Last updated
- Apr 25, 2024
- 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 | PS52098 | FL | Primary |
Addresses
Primary practice location
1816 Dunlawton Ave
Port Orange, FL 32127-2921
Mailing address
615 E 3Rd Ave
New Smyrna Beach, FL 32169-3133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS52098 | Other | FL | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amanda.sharp@cvshealth.com | Direct |
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 |
|---|---|---|---|
| PS52098 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS 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": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1326642463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 E 3RD AVE",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321693133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1816 DUNLAWTON AVE",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321272921",
"telephone_number": "386-322-3919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARP",
"first_name": "AMANDA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS52098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PS52098",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amanda.sharp@cvshealth.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1816 Dunlawton Ave",
"city": "Port Orange",
"state": "FL",
"country_code": "US",
"postal_code": "321272921",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.