Individual provider Active NPI

Amy Iannarone, PHARM D

  • Pharmacist
  • Clarkston, MI
National Provider Identifier
1962049783
Registry record updated Dec 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302040359 Issued in MI
Practice address
9741 Dixie Hwy
Clarkston, MI 48348-4145
Phone
(248) 922-0468
NPI assigned
Dec 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302040359 MI Primary

Addresses

Primary practice location

9741 Dixie Hwy
Clarkston, MI 48348-4145

Mailing address

5415 Inverrary LN
Commerce TWP, MI 48382-1010

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
5302040359MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co of Michigan PastSince Dec 9, 2019 Accepting new patients
Kroger Co of Michigan PastSince Dec 9, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1575158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575158400000",
    "number": "1962049783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 INVERRARY LN",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483821010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9741 DIXIE HWY",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484145",
            "telephone_number": "248-922-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNARONE",
        "first_name": "AMY",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-01",
        "last_updated": "2019-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302040359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.