Active NPI
Ammon Niels Landon Mitchell, PHARMD
- Pharmacist
- Shenandoah, IA
National Provider Identifier
1649864059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24047
- Practice address
- 705 S Fremont St
Shenandoah, IA 51601-1570 - Phone
- (712) 246-4033
- NPI assigned
- Feb 25, 2021
- Last updated
- Feb 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 24047 | IA | Primary |
Addresses
Primary practice location
705 S Fremont St
Shenandoah, IA 51601-1570
Mailing address
24417 Brothers Ave
Glenwood, IA 51534-5083
Phone (402) 871-1035
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 |
|---|---|---|---|
| 24047 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart 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": "1614211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1649864059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24417 BROTHERS AVE",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "515345083",
"telephone_number": "402-871-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S FREMONT ST",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516011570",
"telephone_number": "712-246-4033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "AMMON",
"middle_name": "NIELS LANDON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-25",
"last_updated": "2021-02-25",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "24047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, IA
- Linda Micheel
- Crystal Lynn Mick, ARNP, PMHNP-BC
- Midwest Mental Health LLC (Midwest Mental Health)
- Midwest Senior Care, LLC (Seniors Helping Seniors)
- Millennium Chiropractic PC
- Michael J Morrison, M.D.
- Jacob Walter Muller, O.D.
- Edanne Lynn Murphy
- Kenneth James Myrberg, DDS
- Warren A Narducci, PHARM.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.