Active NPI
Valentina Pidkalyuk, PHARMD
- Pharmacist
- Green Bay, WI
National Provider Identifier
1235415605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14846-40
- Practice address
- 2204 University Ave
Green Bay, WI 54302-4511 - Phone
- (920) 469-5516
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- 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 | 14846-40 | WI | Primary |
Addresses
Primary practice location
2204 University Ave
Green Bay, WI 54302-4511
Mailing address
2204 University Ave
Green Bay, WI 54302-4511
Phone (920) 469-5516
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 |
|---|---|---|---|
| 14846-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1235415605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 UNIVERSITY AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543024511",
"telephone_number": "920-469-5516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 UNIVERSITY AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543024511",
"telephone_number": "920-469-5516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIDKALYUK",
"first_name": "VALENTINA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-28",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14846-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.