Matthew Russell Dierks, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

14941-040 Issued in WI

Practice address

600 Highland Ave
F6/133-1530
Madison, WI 53792-0001

Phone

(608) 263-1284

NPI assigned

Sep 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201392000000",
    "number": "1164617817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "F6/133-1530",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "F6/133-1530",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKS",
        "first_name": "MATTHEW",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2008-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "14941-040",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26022406A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia A Diehl, R.N.
• Helita Jacqueline Diels
• Gretchen A Diem, PHD
• Candice Nicole Dienberg, LCSW, SAC
• Danielle A Dieringer, MSSW, LCSW
• Ward Dieter, PA
• Julie Mary Dieterle, P.T.
• Michael Gerald Dieterle, MD, PHD
• Bokaye M. Dietmeier, OD
• David J Dietrich

• Pharmacist in Madison, WI
• Providers in Madison, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2008; 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.