Individual provider Active NPI

Greg William Hebl

  • Pharmacist
  • Madison, WI
National Provider Identifier
1013292184
Registry record updated Feb 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10743-010 Issued in WI
Practice address
4641 Verona Rd
Madison, WI 53711-2736
Phone
(608) 271-7822
Fax
(608) 271-3657
NPI assigned
Oct 19, 2011
Last updated
Feb 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10743-010 WI Primary

Addresses

Primary practice location

4641 Verona Rd
Madison, WI 53711-2736

Mailing address

4641 Verona Rd
Madison, WI 53711-2736
Phone (608) 271-7822

Other identifiers 1

IdentifierTypeStateIssuer
33023100MedicaidWI

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

LicenseStateTypeSpecialty
10743-010WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329523200000",
    "number": "1013292184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 VERONA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112736",
            "telephone_number": "608-271-7822",
            "fax_number": "608-271-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 VERONA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112736",
            "telephone_number": "608-271-7822",
            "fax_number": "608-271-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBL",
        "first_name": "GREG",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2012-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "10743-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33023100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2012; 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.