Individual provider Active NPI

Rachel Grace Dutton, PHARMD

  • Pharmacist
  • Black River Falls, WI
National Provider Identifier
1013425883
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20263-40 Issued in WI
Practice address
N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405
Phone
(715) 284-9851
Fax
(715) 284-2293
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 121584 MN
Pharmacist 183500000X 20263-40 WI Primary

Addresses

Primary practice location

N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405

Mailing address

N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405
Phone (715) 284-9851

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
121584MNMDPharmacist
20263-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1013425883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6520 LUMBERJACK GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6520 LUMBERJACK GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "RACHEL",
        "middle_name": "GRACE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "121584",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "20263-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.