Amanda Gayle Walters, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2008012654 Issued in MO

Practice address

3410 Red Bay Creek Rd
Columbia, MO 65203-9097

Phone

(573) 874-3562

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1760766117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 RED BAY CREEK RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039097",
            "telephone_number": "573-874-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 RED BAY CREEK RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039097",
            "telephone_number": "573-874-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "AMANDA",
        "middle_name": "GAYLE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2008012654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Lyn Wallace, OTR/L
• Erika McGraw Waller, PH.D.
• Marcia J Walmer, RN, AP/MHNP
• Hailey Walsh, MS, LPC
• Walter R. Pfitzinger D.D.S,, P.C.
• Heather Michelle Walters, RN
• Nikesha Walters, DMD
• Walton CS XV Inc
• Nikehl J Walton
• Barbara L Walts, LCSW

• Pharmacist in Columbia, MO
• Providers in Columbia, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.