Active NPI
Susan Gorski, RPH
- Pharmacist
- Wisconsin Dells, WI
National Provider Identifier
1073894473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12250
- Practice address
- 300 State Highway 13
Wisconsin Dells, WI 53965-7902 - Phone
- (608) 254-5760
- NPI assigned
- Aug 30, 2011
- Last updated
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 12250 | WI | Primary |
Addresses
Primary practice location
300 State Highway 13
Wisconsin Dells, WI 53965-7902
Mailing address
300 State Highway 13
Wisconsin Dells, WI 53965-7902
Phone (608) 254-5760
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 |
|---|---|---|---|
| 12250 | WI | MD | Pharmacist |
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": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1073894473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 STATE HIGHWAY 13",
"city": "WISCONSIN DELLS",
"state": "WI",
"postal_code": "539657902",
"telephone_number": "608-254-5760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 STATE HIGHWAY 13",
"city": "WISCONSIN DELLS",
"state": "WI",
"postal_code": "539657902",
"telephone_number": "608-254-5760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORSKI",
"first_name": "SUSAN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wisconsin Dells, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.