Active NPI
Katie Leann Ireland, PHARM D
- Pharmacist
- Vandalia, IL
National Provider Identifier
1629671987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051295212
- Practice address
- 1401 N 8TH St
Vandalia, IL 62471-1028 - Phone
- (618) 283-0196
- Fax
- (618) 283-9150
- NPI assigned
- Nov 19, 2020
- Last updated
- Nov 19, 2020
- 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 | 051295212 | IL | Primary |
Addresses
Primary practice location
1401 N 8TH St
Vandalia, IL 62471-1028
Mailing address
643 E 1250 Ave
Vandalia, IL 62471-4044
Phone (618) 780-9256
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051295212 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1629671987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "643 E 1250 AVE",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624714044",
"telephone_number": "618-780-9256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 N 8TH ST",
"city": "VANDALIA",
"state": "IL",
"postal_code": "624711028",
"telephone_number": "618-283-0196",
"fax_number": "618-283-9150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRELAND",
"first_name": "KATIE",
"middle_name": "LEANN",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051295212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vandalia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.