Individual provider Active NPI

Jon Adam Woebkenberg, PHARMD

  • Pharmacist
  • Princeton, IN
National Provider Identifier
1134720253
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26020449A Issued in IN
Practice address
2700 W Broadway St
Princeton, IN 47670-9418
Phone
(812) 386-6690
NPI assigned
Nov 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 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 26020449A IN Primary

Addresses

Primary practice location

2700 W Broadway St
Princeton, IN 47670-9418

Mailing address

10710 Decatur CT
Evansville, IN 47725-9289
Phone (812) 568-5819

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
26020449AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1134720253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 DECATUR CT",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477259289",
            "telephone_number": "812-568-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W BROADWAY ST",
            "city": "PRINCETON",
            "state": "IN",
            "postal_code": "476709418",
            "telephone_number": "812-386-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOEBKENBERG",
        "first_name": "JON",
        "middle_name": "ADAM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26020449A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.