Individual provider Active NPI

Alyssa Vonderheide, RPH

  • Pharmacist
  • Jasper, IN
National Provider Identifier
1720513518
Registry record updated Apr 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26019867 Issued in IN
Practice address
723 3Rd Ave
Jasper, IN 47546-3639
Phone
(812) 482-9442
NPI assigned
Apr 29, 2017
Last updated
Apr 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26019867 IN Primary

Addresses

Primary practice location

723 3Rd Ave
Jasper, IN 47546-3639

Mailing address

723 3Rd Ave
Jasper, IN 47546-3639
Phone (812) 482-9442

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26019867INMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493424000000",
    "number": "1720513518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 3RD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463639",
            "telephone_number": "812-482-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 3RD AVE",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463639",
            "telephone_number": "812-482-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDERHEIDE",
        "first_name": "ALYSSA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2017-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26019867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2017; 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.