Active NPI
Amy Miller
- Pharmacist
- Bettendorf, IA
National Provider Identifier
1689955635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17268
- Practice address
- 3425 Middle Rd
Bettendorf, IA 52722-3404 - Phone
- (563) 332-6049
- NPI assigned
- Sep 5, 2011
- Last updated
- Sep 6, 2011
- 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 | 17268 | IA | Primary |
Addresses
Primary practice location
3425 Middle Rd
Bettendorf, IA 52722-3404
Mailing address
3425 Middle Rd
Bettendorf, IA 52722-3404
Phone (563) 332-6049
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17268 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1315180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1689955635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3425 MIDDLE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223404",
"telephone_number": "563-332-6049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3425 MIDDLE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527223404",
"telephone_number": "563-332-6049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-05",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "17268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.