Active NPI
Rodneyt Tester
- Pharmacist
- Superior, WI
National Provider Identifier
1073898060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13567-40
- Practice address
- 2015 Tower Ave
Superior, WI 54880-2538 - Phone
- (715) 392-9550
- Fax
- (715) 392-3724
- NPI assigned
- Oct 21, 2011
- Last updated
- Oct 21, 2011
- 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 | 13567-40 | WI | Primary |
Addresses
Primary practice location
2015 Tower Ave
Superior, WI 54880-2538
Mailing address
2015 Tower Ave
Superior, WI 54880-2538
Phone (715) 392-9550
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 |
|---|---|---|---|
| 13567-40 | 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": "1319155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1073898060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 TOWER AVE",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802538",
"telephone_number": "715-392-9550",
"fax_number": "715-392-3724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 TOWER AVE",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802538",
"telephone_number": "715-392-9550",
"fax_number": "715-392-3724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESTER",
"first_name": "RODNEYT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-21",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13567-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Superior, WI
- Target Corporation (Target Pharmacy)
- Michelle Tavera, DPT
- Taylor McClung Psychotherapy PLLC
- Amber Lee Tenerelli, DPT
- Olga Mikhaylovna Ter-Grigoryan
- The Creative Counseling Group
- The Duluth Clinic, LTD (Duluth Clinic at Fresenius Superior Dialysis Unit)
- The Duluth Clinic, LTD (Essentia Health Superior Pharmacy)
- The Duluth Clinic, LTD (Superior Clinic)
- The Duluth Clinic, LTD (Essentia Health Specialty Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.