Individual provider Active NPI

Amanda Marie Leister, PHARM.D., M.S.

  • Pharmacist
  • Holly Springs, NC
National Provider Identifier
1710328422
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23412 Issued in NC
Practice address
251 N Main St
Holly Springs, NC 27540-9194
Phone
(919) 557-5322
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23412 NC Primary

Addresses

Primary practice location

251 N Main St
Holly Springs, NC 27540-9194

Mailing address

204 Dutch Hill Rd
Holly Springs, NC 27540-8525
Phone (919) 604-3496

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
Master of Science, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
23412NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Edc Drug Stores Inc Past Accepting new patients
Edc Drug Stores 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1710328422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 DUTCH HILL RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408525",
            "telephone_number": "919-604-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N MAIN ST",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409194",
            "telephone_number": "919-557-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISTER",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "23412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.