Active NPI
Holly Tangeman
- Pharmacist
- Stoughton, WI
National Provider Identifier
1073899423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3790-040
- Practice address
- 1705 US Highway 51 and 138
Stoughton, WI 53589-1907 - Phone
- (608) 773-7612
- NPI assigned
- Oct 31, 2011
- Last updated
- Oct 31, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3790-040 | WI | Primary |
| Pharmacist | 183500000X | 051.039601 | IL |
Addresses
Primary practice location
1705 US Highway 51 and 138
Stoughton, WI 53589-1907
Mailing address
1705 US Highway 51 and 138
Stoughton, WI 53589-1907
Phone (608) 773-7612
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 |
|---|---|---|---|
| 051.039601 | IL | MD | Pharmacist |
| 3790-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1073899423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 US HIGHWAY 51 AND 138",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891907",
"telephone_number": "608-773-7612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 US HIGHWAY 51 AND 138",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891907",
"telephone_number": "608-773-7612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANGEMAN",
"first_name": "HOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "3790-040",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.039601",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, WI
- Stoughton Hospital Association
- Stoughton Meadows Assisted Living Facility
- Stoughton Senior Living, Inc. (Stoughton Meadows Assisted Living)
- Asfiya Batool Syeda, PHARMD
- Amy Renee Taebel, PT, PCS
- Renee Annette Taylor, NDTR
- Robert E. Terbrack, D.O.
- Thomas Nelson Thies, DDS
- Chris Alan Thomas II, NP
- Three Gaits, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.