Active NPI
Amy Niewald
- Pharmacist
- Immokalee, FL
National Provider Identifier
1336535574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53007
- Practice address
- 1450 Immokalee Dr
Immokalee, FL 34142-3420 - Phone
- (239) 658-2362
- NPI assigned
- Apr 14, 2015
- Last updated
- Apr 14, 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 | PS53007 | FL | Primary |
Addresses
Primary practice location
1450 Immokalee Dr
Immokalee, FL 34142-3420
Mailing address
5230 Beckton Rd
Ave Maria, FL 34142-5035
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 |
|---|---|---|---|
| PS53007 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1428969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1336535574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 BECKTON RD",
"city": "AVE MARIA",
"state": "FL",
"postal_code": "341425035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 IMMOKALEE DR",
"city": "IMMOKALEE",
"state": "FL",
"postal_code": "341423420",
"telephone_number": "239-658-2362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEWALD",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-14",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Immokalee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.