Alex Egon Muelder, PHARMD

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

19571-40 Issued in WI

Practice address

6462 S 27TH St
Oak Creek, WI 53154-1036

Phone

(414) 761-1550

Fax

(414) 761-1682

NPI assigned

Sep 19, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1235789397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6462 S 27TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541036",
            "telephone_number": "414-761-1550",
            "fax_number": "414-761-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6462 S 27TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541036",
            "telephone_number": "414-761-1550",
            "fax_number": "414-761-1682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6462 S 27th St",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531541036",
            "country_code": "US",
            "telephone_number": "414-761-1550",
            "fax_number": "414-761-1682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELDER",
        "first_name": "ALEX",
        "middle_name": "EGON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "19571-40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "1951-40",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.