Active NPI
Ryan Debauche
- Pharmacist
- Oshkosh, WI
National Provider Identifier
1003655028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20354-40
- Practice address
- 855 N Westhaven Dr
Oshkosh, WI 54904-7668 - Phone
- (920) 303-8830
- NPI assigned
- May 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20354-40 | WI | Primary |
Addresses
Primary practice location
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Mailing address
2048 W Roberts Ave
Appleton, WI 54914-1897
Phone (920) 615-2526
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20354-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1003655028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2048 W ROBERTS AVE",
"city": "APPLETON",
"state": "WI",
"postal_code": "549141897",
"telephone_number": "920-615-2526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N WESTHAVEN DR",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047668",
"telephone_number": "920-303-8830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBAUCHE",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "20354-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.