Individual provider Active NPI

Dalton Geisler

  • Pharmacist
  • Decatur, IL
National Provider Identifier
1093319451
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.298617 Issued in IL
Practice address
2990 N Monroe St
Decatur, IL 62526-3266
Phone
(217) 877-1703
Fax
(217) 876-7540
NPI assigned
Nov 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.298617 IL Primary

Addresses

Primary practice location

2990 N Monroe St
Decatur, IL 62526-3266

Mailing address

2990 N Monroe St
Decatur, IL 62526-3266
Phone (217) 877-1703

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

LicenseStateTypeSpecialty
051.298617ILMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1093319451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 N MONROE ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263266",
            "telephone_number": "217-877-1703",
            "fax_number": "217-876-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N MONROE ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263266",
            "telephone_number": "217-877-1703",
            "fax_number": "217-876-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEISLER",
        "first_name": "DALTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.298617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.

Verify at the official NPI Registry.