DR. AMY LOUISE MATTILA (NPI# 1164020764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164020764 |
| Entity Type | Individual |
| Full Name | DR. AMY LOUISE MATTILA |
| Practice Address |
2500 Lake Shore Dr E Ashland WI 54806-2421 |
| Mailing Address |
200 Gary Rd Washburn WI 54891-5402 |
| Practice Telephone | 7156823660 |
| Practice Fax Number | 7156859941 |
| Mailing Telephone | 7156858102 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 11406 | WI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508231697 | Amy Mattila | Health Educator | 300 Broadway St, #202, Saint Paul, MN 55101-1440 | 2015-12-01 |
| 1992802797 | Amy M Mattila | Occupational Therapist | 936 Angelo Dr, Pittsburgh, PA 15236-2205 | 2006-09-20 |
| Street Address |
2500 LAKE SHORE DR E |
| City | ASHLAND |
| State | WI |
| Zip Code | 54806-2421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992722045 | Wal-mart Stores East Lp | Pharmacy | 2500 Lake Shore Dr E, Ashland, WI 54806-2421 | 2006-07-16 |
| 1497354757 | Grace M Kilbane | Pharmacist | 2500 Lake Shore Dr E, Ashland, WI 54806-2421 | 2020-10-19 |
| 1861091233 | James Robert Bratley | Pharmacist | 2500 Lake Shore Dr E, Ashland, WI 54806-2421 | 2020-10-18 |
| 1962001339 | Katie Rose Swanson | Pharmacist | 2500 Lake Shore Dr E, Ashland, WI 54806-2421 | 2020-10-18 |
| 1851999320 | Donald Bradley Massopust | Pharmacist | 2500 Lake Shore Dr E, Ashland, WI 54806-2421 | 2020-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992236525 | Robin Jurgensen | Counselor | 1619 W Third Street, Ashland, WI 54806 | 2017-03-24 |
| 1922479195 | Alexa M Honstad | Registered Nurse | Memorial Medical Center, Inc, 1615 Maple Lane, Ashland, WI 54806 | 2015-10-14 |
| 1982032728 | Noel Hong | Pharmacist | 1800 Us Highway 2, Ashland, WI 54806 | 2013-10-14 |
| 1588909402 | Kelli Danielle Culver | Registered Nurse | 216 3rd St W Ste 201, Ashland, WI 54806 | 2012-12-04 |
| 1114191756 | Karen Keyes | Occupational Therapist | 1635 Maple Lane, Behavioral Health Services, Ashland, WI 54806 | 2008-04-15 |
| 1174645204 | Michael Allyn Turgeon | Social Worker | 517 Beaser Avenue, Ashland, WI 54806 | 2007-04-06 |
| 1770669269 | Laura Anton Ia Nitsche | Speech-Language Pathologist | 618 Beaser Avenue, Ashland, WI 54806 | 2006-10-27 |
| 1104915222 | Patrick Alan Hickman | Chiropractor | 400 East Lakeshore Drive, Ashland, WI 54806 | 2006-10-12 |
| 1386732113 | Janet Lee Sternat | Physical Therapist | 618 Beaser Ave, Cesa #12, Ashland, WI 54806 | 2006-10-10 |
| 1295743193 | Ashland Dental Clinic Inc | Dentist | 300 9th Ave W, Ashland, WI 54806 | 2006-08-04 |
| Find all providers in zip 54806 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973774 | Pam Mimms | Pharmacist | 20 Raymond Way, Ashland, MA 01721-2430 | 2019-07-13 |
| 1619441490 | Jordan Ware | Pharmacist | 711 12th St, Ashland, KY 41101-2668 | 2019-01-15 |
| 1588171847 | Belinda Foster | Pharmacist | 419 Claremont Ave, Ashland, OH 44805 | 2018-01-08 |
| 1477095495 | Jordan Nicholls | Pharmacist | 210 Providence Hill Dr, Apt. 146, Ashland, KY 41101-2294 | 2016-11-08 |
| 1922476076 | Suellen Datkuliak | Pharmacist | 1867 County Road 655, Ashland, OH 44805-9384 | 2015-09-07 |
| 1003218173 | Andrew Benson | Pharmacist | 53 N. 2nd St, Ashland, OR 97520 | 2014-09-20 |
| 1669882684 | Jeanette Louise Quinn | Pharmacist | 603 Dogwood Ct, Ashland, MO 65010-9012 | 2014-04-29 |
| 1982032728 | Noel Hong | Pharmacist | 1800 Us Highway 2, Ashland, WI 54806 | 2013-10-14 |
| 1831526144 | Charles Schink | Pharmacist | 1212 Old Willow Ln, Ashland, OR 97520-1341 | 2013-10-01 |
| 1528490638 | Sandip G Patel | Pharmacist | 626 W Center St, Ashland, PA 17921-1332 | 2013-07-31 |
| Find all providers in ASHLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.