Teel Ryan Wisdom, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2011021865 Issued in MO

Practice address

117 W 4TH St
Salem, MO 65560-1255

Phone

(573) 729-4114

Fax

(573) 729-5353

NPI assigned

Oct 24, 2012

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Town & Country Super Market Inc

  dba Country Mart Pharmacy #2425

  • Community/Retail Pharmacy
  • Steelville, MO
  • NPI 1952382913
  NPD (past)
• Town and Country Super Market Inc

  dba Town & Country Pharmacy #688

  • Community/Retail Pharmacy
  • Piedmont, MO
  • NPI 1457844748
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1245583566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601255",
            "telephone_number": "573-729-4114",
            "fax_number": "573-729-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655601255",
            "telephone_number": "573-729-4114",
            "fax_number": "573-729-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 E Hwy 8",
            "address_purpose": "LOCATION",
            "city": "Steelville",
            "state": "MO",
            "postal_code": "655650561",
            "country_code": "US",
            "telephone_number": "573-775-4666",
            "fax_number": "573-775-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "TEEL",
        "middle_name": "RYAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-24",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2011021865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Lee White, OD
• Carrie Lynn Wilber, M.S.,CCC-SLP
• Jamie Johnston Wilson, PTA
• Wisdom Counseling and Consultation
• Wisdom Therapy LLC (Stepping Stones Counseling Center)
• Lathan Dean Wise
• Dawson Tate Wynn, ATS

• Pharmacist in Salem, MO
• Providers in Salem, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.