Active NPI
Trevor Bauer, PHARMD
- Pharmacist
- Black River Falls, WI
National Provider Identifier
1174993547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17874-040
- Practice address
- 611 State Highway 54
Black River Falls, WI 54615-5453 - Phone
- (715) 284-9115
- Fax
- (715) 284-5330
- NPI assigned
- Sep 29, 2015
- Last updated
- Sep 29, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 17874-040 | WI | Primary |
Addresses
Primary practice location
611 State Highway 54
Black River Falls, WI 54615-5453
Mailing address
611 State Highway 54
Black River Falls, WI 54615-5453
Phone (715) 284-9115
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17874-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1174993547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 STATE HIGHWAY 54",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546155453",
"telephone_number": "715-284-9115",
"fax_number": "715-284-5330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 STATE HIGHWAY 54",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546155453",
"telephone_number": "715-284-9115",
"fax_number": "715-284-5330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "TREVOR",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-29",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17874-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Black River Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.