Active NPI
Kenneth S Kolar, PHARMD
- Pharmacist
- Suamico, WI
National Provider Identifier
1073156758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13282-40
- Practice address
- 3304 Shady LN
Suamico, WI 54313-8712 - Phone
- (920) 503-0003
- NPI assigned
- Oct 24, 2019
- Last updated
- May 6, 2020
- Sex
- Male
- 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 | 13282-40 | WI | Primary |
Addresses
Primary practice location
3304 Shady LN
Suamico, WI 54313-8712
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 445-7222
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13282-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588723200000",
"number": "1073156758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3304 SHADY LN",
"city": "SUAMICO",
"state": "WI",
"postal_code": "543138712",
"telephone_number": "920-503-0003"
}
],
"practiceLocations": [
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLAR",
"first_name": "KENNETH",
"middle_name": "S",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-24",
"last_updated": "2020-05-06",
"certification_date": "2020-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13282-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suamico, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.