Active NPI
Brad Richardson
- Pharmacist
- Neenah, WI
National Provider Identifier
1184237562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20665-40
- Practice address
- 1191 Westowne Dr
Neenah, WI 54956-2176 - Phone
- (920) 725-3152
- NPI assigned
- Aug 26, 2020
- Last updated
- Jun 16, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20665-40 | WI | Primary |
| Pharmacist | 183500000X | 20124 | NV |
Addresses
Primary practice location
1191 Westowne Dr
Neenah, WI 54956-2176
Mailing address
1191 Westowne Dr
Neenah, WI 54956-2176
Phone (920) 725-3152
Other practice location 1
770 S Highway 160
Pahrump, NV 89048
Phone (775) 751-8399
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20124 | NV | MD | Pharmacist |
| 20665-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1191 Westowne Dr
Neenah, WI 54956
Phone (920) 723-5315
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1184237562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1191 WESTOWNE DR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562176",
"telephone_number": "920-725-3152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1191 WESTOWNE DR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562176",
"telephone_number": "920-725-3152"
}
],
"practiceLocations": [
{
"address_1": "770 S HIGHWAY 160",
"address_purpose": "LOCATION",
"city": "Pahrump",
"state": "NV",
"postal_code": "89048",
"country_code": "US",
"telephone_number": "775-751-8399",
"fax_number": "775-751-8864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARDSON",
"first_name": "BRAD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-26",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "20665-40",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "20124",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.