Active NPI
Katherine Wollum
- Pharmacist
- Bloomer, WI
National Provider Identifier
1245840362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19091
- Practice address
- 1511 Main St
Bloomer, WI 54724-1683 - Phone
- (715) 568-2190
- NPI assigned
- Aug 4, 2020
- 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 | 19091 | WI | Primary |
Addresses
Primary practice location
1511 Main St
Bloomer, WI 54724-1683
Mailing address
1324 W Clairemont Ave Ste 3
Eau Claire, WI 54701-6191
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19091 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1245840362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 W CLAIREMONT AVE STE 3",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 MAIN ST",
"city": "BLOOMER",
"state": "WI",
"postal_code": "547241683",
"telephone_number": "715-568-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLLUM",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-04",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.