Active NPI
Amy Gannon, RPH
- Pharmacist
- Middletown, RI
National Provider Identifier
1467779280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH03795
- Practice address
- 12 E Main Rd
Middletown, RI 02842-4912 - Phone
- (401) 847-8520
- NPI assigned
- May 3, 2010
- Last updated
- Jul 4, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH22822 | MA | |
| Pharmacist | 183500000X | RPH03795 | RI | Primary |
Addresses
Primary practice location
12 E Main Rd
Middletown, RI 02842-4912
Mailing address
12 E Main Rd
Middletown, RI 02842-4912
Phone (401) 847-8520
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH22822 | MA | MD | Pharmacist |
| RPH03795 | RI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | 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": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404432000000",
"number": "1467779280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 E MAIN RD",
"city": "MIDDLETOWN",
"state": "RI",
"postal_code": "028424912",
"telephone_number": "401-847-8520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 E MAIN RD",
"city": "MIDDLETOWN",
"state": "RI",
"postal_code": "028424912",
"telephone_number": "401-847-8520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "AMY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-03",
"last_updated": "2014-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH22822",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH03795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.