Individual provider Active NPI

Peter Altfillisch, RPH

  • Pharmacist
  • Sherwood, WI
National Provider Identifier
1053666768
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13213-40 Issued in WI
Practice address
W5077 Cherrywood CT
Sherwood, WI 54169-9510
Phone
(920) 507-8012
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 13213-40 WI Primary

Addresses

Primary practice location

W5077 Cherrywood CT
Sherwood, WI 54169-9510

Mailing address

W5077 Cherrywood CT
Sherwood, WI 54169-9510
Phone (920) 507-8012

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

LicenseStateTypeSpecialty
13213-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1053666768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5077 CHERRYWOOD CT",
            "city": "SHERWOOD",
            "state": "WI",
            "postal_code": "541699510",
            "telephone_number": "920-507-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5077 CHERRYWOOD CT",
            "city": "SHERWOOD",
            "state": "WI",
            "postal_code": "541699510",
            "telephone_number": "920-507-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTFILLISCH",
        "first_name": "PETER",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13213-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, WI

Sources for this page

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