Active NPI
William Douglas Antle, R. PH.
- Pharmacist
- Louisville, KY
National Provider Identifier
1609910090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 008276
- Practice address
- 2200 Dundee Rd
Louisville, KY 40205-1828 - Phone
- (502) 452-2678
- NPI assigned
- Feb 18, 2007
- Sex
- Male
- 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 | 008276 | KY | Primary |
Addresses
Primary practice location
2200 Dundee Rd
Louisville, KY 40205-1828
Mailing address
3103 Thousand Oaks Dr
Louisville, KY 40205-2701
Phone (502) 456-4999
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1819448 | Other | KY | NABP NUMBER |
| 54023585 | Medicaid | KY |
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 |
|---|---|---|---|
| 008276 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609910090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 THOUSAND OAKS DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402052701",
"telephone_number": "502-456-4999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 DUNDEE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402051828",
"telephone_number": "502-452-2678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTLE",
"first_name": "WILLIAM",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "R. PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "008276",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP NUMBER",
"identifier": "1819448",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54023585",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.