Active NPI
Joni Penn, RPH
- Pharmacist
- Cudahy, WI
National Provider Identifier
1104102938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11416-40
- Practice address
- 3201 E Layton Ave
Cudahy, WI 53110-1402 - Phone
- (414) 481-8220
- NPI assigned
- Oct 25, 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 | 11416-40 | WI | Primary |
Addresses
Primary practice location
3201 E Layton Ave
Cudahy, WI 53110-1402
Mailing address
3201 E Layton Ave
Cudahy, WI 53110-1402
Phone (414) 481-8220
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 |
|---|---|---|---|
| 11416-40 | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1104102938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 E LAYTON AVE",
"city": "CUDAHY",
"state": "WI",
"postal_code": "531101402",
"telephone_number": "414-481-8220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 E LAYTON AVE",
"city": "CUDAHY",
"state": "WI",
"postal_code": "531101402",
"telephone_number": "414-481-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "JONI",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-25",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11416-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cudahy, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.