Amanda Jean Bozell, PHARM.D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

16940 Issued in OK

Practice address

4720 S Harvard Ave Ste 100
Tulsa, OK 74135-3023

Phone

(918) 749-6730

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Jean Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1861922650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 S 198TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740141372",
            "telephone_number": "580-747-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 S HARVARD AVE STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353023",
            "telephone_number": "918-749-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZELL",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OK",
            "license": "16940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILSON",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Boyne
• Nicholas Stephen Boyne
• Patrick Boyne
• Darryl Wayne Boynton
• Summer Boynton
• Piper Jane Bozeman
• Carrie A Bozone
• Leslie Bozworth, RN
• Tyler Braaten, M.D.
• Donna Bracciale, DO

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.