Individual provider Active NPI

Courtney Rudisill, PHARMD

  • Pharmacist
  • Reedsburg, WI
National Provider Identifier
1033710280
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17806-40 Issued in WI
Practice address
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone
(608) 524-6487
Fax
(608) 524-6299
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17806-40 WI Primary

Addresses

Primary practice location

2000 N Dewey Ave
Reedsburg, WI 53959-1049

Mailing address

2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone (608) 524-6487

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
17806-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1033710280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N DEWEY AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591049",
            "telephone_number": "608-524-6487",
            "fax_number": "608-524-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N DEWEY AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591049",
            "telephone_number": "608-524-6487",
            "fax_number": "608-524-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDISILL",
        "first_name": "COURTNEY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17806-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.