Active NPI
Edmund Joseph Elder Jr., PH.D.
- Pharmacist
- Madison, WI
National Provider Identifier
1235330028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6368
- Practice address
- 777 Highland Ave
Uw-Madison School of Pharmacy Rennebohm Hall
Madison, WI 53705-2222 - Phone
- (608) 890-1198
- NPI assigned
- May 30, 2007
- 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 | 6368 | SC | Primary |
| Pharmacist | 183500000X | 16206-040 | WI |
Addresses
Primary practice location
777 Highland Ave
Uw-Madison School of Pharmacy Rennebohm Hall
Madison, WI 53705-2222
Mailing address
777 Highland Ave
Madison, WI 53705-2222
Phone (608) 890-1198
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16206-040 | WI | MD | Pharmacist |
| 6368 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1235330028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537052222",
"telephone_number": "608-890-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 HIGHLAND AVE",
"address_2": "UW-MADISON SCHOOL OF PHARMACY RENNEBOHM HALL",
"city": "MADISON",
"state": "WI",
"postal_code": "537052222",
"telephone_number": "608-890-1198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "EDMUND",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-30",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "6368",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "16206-040",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.