Individual provider Active NPI

Christian Robert Bialk, PHARMD

  • Pharmacist
  • Green Bay, WI
National Provider Identifier
1114350527
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17240-40 Issued in WI
Practice address
1001 Cormier Rd
Green Bay, WI 54304-4404
Phone
(920) 499-2608
NPI assigned
Aug 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17240-40 WI Primary

Addresses

Primary practice location

1001 Cormier Rd
Green Bay, WI 54304-4404

Mailing address

1001 Cormier Rd
Green Bay, WI 54304-4404
Phone (920) 499-2608

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

LicenseStateTypeSpecialty
17240-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1114350527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044404",
            "telephone_number": "920-499-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044404",
            "telephone_number": "920-499-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIALK",
        "first_name": "CHRISTIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-21",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17240-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.