Individual provider Active NPI

Andrea Hyatt

  • Pharmacist
  • Dayton, OH
National Provider Identifier
1659872901
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-3-25911 Issued in OH
Practice address
110 N Main St Ste 290
Dayton, OH 45402-3727
Phone
(937) 499-5131
NPI assigned
Feb 22, 2018
Last updated
Feb 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 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 03-3-25911 OH Primary

Addresses

Primary practice location

110 N Main St Ste 290
Dayton, OH 45402-3727

Mailing address

218 Rubicon Rd
Oakwood, OH 45409-2242
Phone (937) 974-2857

Other identifiers 2

IdentifierTypeStateIssuer
03-3-25911OtherOHOSBOP PHARMACIST LICENSE NUMBER
150890OtherNABP CPE E-PROFILE ID

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

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1659872901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 RUBICON RD",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454092242",
            "telephone_number": "937-974-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST STE 290",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454023727",
            "telephone_number": "937-499-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-3-25911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSBOP PHARMACIST LICENSE NUMBER",
            "identifier": "03-3-25911",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP CPE E-PROFILE ID",
            "identifier": "150890",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.