Active NPI
Mini Vijayan Nalini
- Pharmacist
- Grafton, WI
National Provider Identifier
1053689083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16356-40
- Practice address
- 1915 Wisconsin Ave
Grafton, WI 53024-2605 - Phone
- (262) 377-0352
- NPI assigned
- Dec 5, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16356-40 | WI | Primary |
Addresses
Primary practice location
1915 Wisconsin Ave
Grafton, WI 53024-2605
Mailing address
535 Acacia Dr
Grafton, WI 53024-9610
Phone (262) 618-4780
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16356-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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 and National Provider Directory roles.
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1053689083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 ACACIA DR",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530249610",
"telephone_number": "262-618-4780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 WISCONSIN AVE",
"city": "GRAFTON",
"state": "WI",
"postal_code": "530242605",
"telephone_number": "262-377-0352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIJAYAN NALINI",
"first_name": "MINI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "16356-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grafton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.