Individual provider Active NPI

Amanda Wilfong, PHARM. D.

  • Pharmacist
  • Clarksburg, WV
National Provider Identifier
1649572140
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP0006811 Issued in WV
Practice address
W Pike and Smith St
Clarksburg, WV 26301
Phone
(304) 623-2598
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP0006811 WV Primary

Addresses

Primary practice location

W Pike and Smith St
Clarksburg, WV 26301

Mailing address

23 Mere Dr
Clarksburg, WV 26301-5706
Phone (304) 671-1988

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

LicenseStateTypeSpecialty
RP0006811WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1649572140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MERE DR",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263015706",
            "telephone_number": "304-671-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W PIKE AND SMITH ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-623-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFONG",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0006811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.