Active NPI
Judith R Edge, RPH
- Pharmacist
- Belleville, WI
National Provider Identifier
1013201755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11226-40
- Practice address
- 1019 River St Ste 1
Belleville Hometown Pharmacy
Belleville, WI 53508-9181 - Phone
- (608) 424-3364
- NPI assigned
- May 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 11226-40 | WI | Primary |
Addresses
Primary practice location
1019 River St Ste 1
Belleville Hometown Pharmacy
Belleville, WI 53508-9181
Mailing address
W2618 Story Creek Cir
Belleville, WI 53508-8702
Phone (608) 424-3504
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11226-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MD Group LLC | Past | 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.
-
- Community/Retail Pharmacy
- Evansville, WI
- NPI 1598768137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1013201755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W2618 STORY CREEK CIR",
"city": "BELLEVILLE",
"state": "WI",
"postal_code": "535088702",
"telephone_number": "608-424-3504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 RIVER ST STE 1",
"address_2": "BELLEVILLE HOMETOWN PHARMACY",
"city": "BELLEVILLE",
"state": "WI",
"postal_code": "535089181",
"telephone_number": "608-424-3364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGE",
"first_name": "JUDITH",
"middle_name": "R",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-28",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11226-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.