Maya Clare Boguslawski, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

22637 Issued in WI

Practice address

1450 Eastside Rd
Platteville, WI 53818-9800

Phone

(608) 342-4849

NPI assigned

Sep 14, 2023

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Health Center, Inc

  • Critical Access Hospital
  • Platteville, WI
  • NPI 1831279793
  NPD (past)

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1194502831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PRAIRIE HEIGHTS DR APT 201",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535932218",
            "telephone_number": "952-649-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-342-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUSLAWSKI",
        "first_name": "MAYA",
        "middle_name": "CLARE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "24857",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "22637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dallas Karl Bernhardt
• Cody Bertram
• Catherine A Blume, APNP
• Sarah Blume, RN
• Jacquelyne Anne Bodden, MSN RN-C WHNP
• Candace Ann Bolton-Flynn, M.S.
• Hobart H Bosworth, MD
• Michael Lee Bottrell, D.D.S.
• Michelle Marie Brant, PA-C
• Ryanne Elaine Breckenridge, ATC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.