Individual provider Active NPI

Amanda C Bowers, PHARMD

  • Pharmacist
  • Blountville, TN
National Provider Identifier
1891787487
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0000012079 Issued in TN
Practice address
1921 Highway 394
Blountville, TN 37617-5454
Phone
(423) 323-3312
Fax
(423) 323-1836
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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
0000012079TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K VA T Food Stores Inc Past Accepting new patients
K VA T Food Stores Inc Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0000012079 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

1921 Highway 394
Blountville, TN 37617-5454

Mailing address

212 Lake Vista Cir
Piney Flats, TN 37686-3358
Phone (423) 538-0861

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891787487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 LAKE VISTA CIR",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376863358",
            "telephone_number": "423-538-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 HIGHWAY 394",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376175454",
            "telephone_number": "423-323-3312",
            "fax_number": "423-323-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "AMANDA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000012079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blountville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.