Individual provider Active NPI

Amy Susan Boyd, RPH

  • Pharmacist
  • Scott City, MO
National Provider Identifier
1780214619
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2017008176 Issued in MO
Practice address
2220 Main St
Scott City, MO 63780-1329
Phone
(573) 264-2450
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051288334 IL
Pharmacist 183500000X 2017008176 MO Primary

Addresses

Primary practice location

2220 Main St
Scott City, MO 63780-1329

Mailing address

2220 Main St
Scott City, MO 63780-1329
Phone (573) 264-2450

Other practice location 1

465 S Mount Auburn Rd
Cape Girardeau, MO 63703-4937
Phone (573) 651-5250

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
2017008176MOMDPharmacist
051288334ILMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Pharmacy LLC CurrentSince Dec 24, 2023 Accepting new patients
North Carolina CVS Pharmacy LLC PastSince Jul 1, 2023 Accepting new patients
Kroger Limited Partnership I PastSince Jan 1, 2020 Accepting new patients
Cape Pharmacy, LLC PastSince Dec 24, 2023 Accepting new patients
Kroger Limited Partnership I PastSince Jan 1, 2020 Accepting new patients
Missouri CVS Pharmacy LLC PastSince Jul 1, 2023 Accepting new patients

Locations

2220 Main St
Scott City, MO 63780
Phone (573) 264-2450

Organizations & group practices 6

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": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1780214619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 MAIN ST",
            "city": "SCOTT CITY",
            "state": "MO",
            "postal_code": "637801329",
            "telephone_number": "573-264-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 MAIN ST",
            "city": "SCOTT CITY",
            "state": "MO",
            "postal_code": "637801329",
            "telephone_number": "573-264-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 S Mount Auburn Rd",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637034937",
            "country_code": "US",
            "telephone_number": "573-651-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "AMY",
        "middle_name": "SUSAN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051288334",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2017008176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.