Individual provider Active NPI

Amanda Dawn Woodle Stewart

  • Pharmacist
  • Boalsburg, PA
National Provider Identifier
1659842763
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP44486 Issued in PA
Practice address
110 Rolling Ridge Drive
Boalsburg, PA 16827
Phone
(814) 231-8399
NPI assigned
Dec 16, 2018
Last updated
Dec 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP44486 PA Primary

Addresses

Primary practice location

110 Rolling Ridge Drive
Boalsburg, PA 16827

Mailing address

75 Emma CT
Boalsburg, PA 16827-1454
Phone (814) 574-3637

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

State licenses

LicenseStateTypeSpecialty
RP44486PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1659842763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 EMMA CT",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "168271454",
            "telephone_number": "814-574-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ROLLING RIDGE DRIVE",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "16827",
            "telephone_number": "814-231-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODLE STEWART",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP44486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boalsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.