Individual provider Active NPI

Kristi K Fecik, PHARM D

  • Pharmacist
  • Eau Claire, WI
National Provider Identifier
1013113307
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
117994 Issued in MN
Practice address
733 W Clairemont Ave
Eau Claire, WI 54701-6117
Phone
(715) 838-5000
Fax
(715) 838-6982
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 117994 MN Primary

Addresses

Primary practice location

733 W Clairemont Ave
Eau Claire, WI 54701-6117

Mailing address

733 W Clairemont Ave
Eau Claire, WI 54701-6117
Phone (715) 838-5000

Other practice location 1

8421 Lyndale Ave S
Bloomington, MN 55420-2235
Phone (952) 346-8625

Other practice location 2

3915 Gateway Dr
Eau Claire, WI 54701-8165
Phone (715) 834-5966

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
117994MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Supervalu Pharmacies Inc Past Accepting new patients
Supervalu Pharmacies Inc. Past 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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1013113307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016117",
            "telephone_number": "715-838-5000",
            "fax_number": "715-838-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016117",
            "telephone_number": "715-838-5000",
            "fax_number": "715-838-6982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8421 Lyndale Ave S",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554202235",
            "country_code": "US",
            "telephone_number": "952-346-8625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3915 Gateway Dr",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547018165",
            "country_code": "US",
            "telephone_number": "715-834-5966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FECIK",
        "first_name": "KRISTI",
        "middle_name": "K",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.