Amanda Lynn Hommel

Primary specialty

PharmacistTaxonomy code 183500000X

License

051290004 Issued in IL

Practice address

1800 Vandalia St
Collinsville, IL 62234-4844

Phone

(618) 344-8473

NPI assigned

Nov 30, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highland Park CVS LLC

  • Pharmacy
  • Collinsville, IL
  • NPI 1740589878
  NPD (past)

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1336744325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 VANDALIA ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344844",
            "telephone_number": "618-344-8473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 VANDALIA ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344844",
            "telephone_number": "618-344-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMMEL",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051290004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Wayne Henson, LCPC, MA CMHC
• Jeffrey P. Herberts, O.D.
• Leann Herschbach
• Highland Park CVS LLC
• Highland Park CVS, L.L.C.
• Kendra Lynn Howell, RNC
• Zachary David Howell, LAT, ATC
• Angela D Huber, MPT
• Alyssa Huckins
• Loren Hughes, M.D.

• All providers in Collinsville, IL
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.