Individual provider Active NPI

Douglas William Wenke, PHARMD

  • Pharmacist
  • Cody, WY
National Provider Identifier
1003141334
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3107 Issued in WY
Practice address
698 Yellowstone Ave
Cody, WY 82414-9322
Phone
(307) 527-6221
NPI assigned
Oct 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3107 WY Primary

Addresses

Primary practice location

698 Yellowstone Ave
Cody, WY 82414-9322

Mailing address

2414 Ina Ave
Cody, WY 82414-9825

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
3107WYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Pharmacy LLC PastSince Mar 13, 2022 Accepting new patients

Organizations & group practices 1

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": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1003141334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 INA AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149322",
            "telephone_number": "307-527-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENKE",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "3107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.