Active NPI
Stephanie Lynn Bondioli, RPH
- Pharmacist
- Oconomowoc, WI
National Provider Identifier
1033490180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13114
- Practice address
- 1284 N Summit Ave
Oconomowoc, WI 53066-4459 - Phone
- (262) 569-8204
- Fax
- (262) 569-8215
- NPI assigned
- Sep 2, 2011
- Last updated
- Jan 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13114 | WI | Primary |
| Pharmacist | 183500000X | 13114-40 | WI |
Addresses
Primary practice location
1284 N Summit Ave
Oconomowoc, WI 53066-4459
Mailing address
1284 N Summit Ave
Oconomowoc, WI 53066-4459
Phone (262) 569-8204
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 |
|---|---|---|---|
| 13114-40 | WI | MD | Pharmacist |
| 13114 | WI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, 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": "1314921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579132800000",
"number": "1033490180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1284 N SUMMIT AVE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664459",
"telephone_number": "262-569-8204",
"fax_number": "262-569-8215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1284 N SUMMIT AVE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664459",
"telephone_number": "262-569-8204",
"fax_number": "262-569-8215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONDIOLI",
"first_name": "STEPHANIE",
"middle_name": "LYNN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-02",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13114",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13114-40",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.