Individual provider Active NPI

Anita Zachariah, PHARMD

  • Pharmacist
  • Kenosha, WI
National Provider Identifier
1124573449
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18367 - 40 Issued in WI
Practice address
5710 75TH St
Kenosha, WI 53142-3635
Phone
(262) 697-5425
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18367 - 40 WI Primary

Addresses

Primary practice location

5710 75TH St
Kenosha, WI 53142-3635

Mailing address

10214 80TH PL
Pleasant Prairie, WI 53158-2052

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
18367 - 40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1124573449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 80TH PL",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531582052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423635",
            "telephone_number": "262-697-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIAH",
        "first_name": "ANITA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "18367 - 40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.