Joel Boerger

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

12813-40 Issued in WI

Practice address

15300 W Grange Ave
New Berlin, WI 53151-7909

Phone

(262) 599-7040

NPI assigned

Jan 28, 2021

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1235720731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W344S9462 JERICHO DR",
            "city": "EAGLE",
            "state": "WI",
            "postal_code": "531191691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 W GRANGE AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531517909",
            "telephone_number": "262-599-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W227N6103 Sussex Rd",
            "address_purpose": "LOCATION",
            "city": "Sussex",
            "state": "WI",
            "postal_code": "530893969",
            "country_code": "US",
            "telephone_number": "414-566-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOERGER",
        "first_name": "JOEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WI",
            "license": "12813-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacotherapy Pharmacist in New Berlin, WI
• Providers in New Berlin, WI by specialty
• Pharmacotherapy Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.