Individual provider Active NPI

Amber L Jerauld, PHARMD

  • Ambulatory Care Pharmacist
  • Vestal, NY
National Provider Identifier
1801099437
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
061501 Issued in NY
Practice address
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 770-7365
Fax
(607) 240-2984
NPI assigned
Jun 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X RP440432 PA
Ambulatory Care Pharmacist 1835P2201X 061501 NY Primary

Addresses

Primary practice location

4417 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 770-7365

Other names 1

  • Amber L Cronk Former name

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP440432PAMDPharmacotherapy Pharmacist
061501NYMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1801099437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-770-7365",
            "fax_number": "607-240-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-770-7365",
            "fax_number": "607-240-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERAULD",
        "first_name": "AMBER",
        "middle_name": "L",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-10",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "PA",
            "license": "RP440432",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NY",
            "license": "061501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "CRONK",
            "middle_name": "L",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.