Active NPI
Andrew Wisnowski, PHARMD
- Pharmacist
- Lake Geneva, WI
National Provider Identifier
1093051856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16310-40
- Practice address
- 351 N Edwards Blvd
Lake Geneva, WI 53147-4563 - Phone
- (262) 248-7885
- NPI assigned
- Dec 26, 2012
- Last updated
- Dec 26, 2012
- 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 | 16310-40 | WI | Primary |
Addresses
Primary practice location
351 N Edwards Blvd
Lake Geneva, WI 53147-4563
Mailing address
706 N 3Rd CT
Silver Lake, WI 53170-1433
Phone (262) 470-7140
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 |
|---|---|---|---|
| 16310-40 | 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, 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": "1356480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356480000000",
"number": "1093051856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 N 3RD CT",
"city": "SILVER LAKE",
"state": "WI",
"postal_code": "531701433",
"telephone_number": "262-470-7140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 N EDWARDS BLVD",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531474563",
"telephone_number": "262-248-7885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISNOWSKI",
"first_name": "ANDREW",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-26",
"last_updated": "2012-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "16310-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Geneva, WI
- Macy Kay Winkelman, PT
- Wisconsin CVS Pharmacy LLC (CVS Pharmacy #17413)
- Wisconsin Illinois Senior Housing Inc. (Geneva Lake Manor)
- David Wise, R.N.
- Thomas Joseph Wisinski, RPH
- Amanda Wolf, APNP
- Katelyn M Woolbright, DPT
- Amanda Joleen Young
- Deborah Lynn Young, APRN, FNP
- Youngquist Kennedy Orthodontics, LTD.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.