Active NPI
Samuel Watkins
- Pharmacist
- Boonville, IN
National Provider Identifier
1760084594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26022458A
- Practice address
- 905 W Main St
Boonville, IN 47601-1567 - Phone
- (812) 897-8828
- NPI assigned
- Nov 16, 2020
- Last updated
- Nov 16, 2020
- Sex
- Male
- 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 | 26022458A | IN | Primary |
Addresses
Primary practice location
905 W Main St
Boonville, IN 47601-1567
Mailing address
7722 W State Route 66
Newburgh, IN 47630-2529
Phone (781) 296-2204
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 |
|---|---|---|---|
| 26022458A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1760084594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7722 W STATE ROUTE 66",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476302529",
"telephone_number": "781-296-2204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 W MAIN ST",
"city": "BOONVILLE",
"state": "IN",
"postal_code": "476011567",
"telephone_number": "812-897-8828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022458A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.