Active NPI
Adam David Matz, PHARMD
- Pharmacist
- Onalaska, WI
National Provider Identifier
1265726368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15328-40
- Practice address
- 9400 State Road 16
Target Pharmacy
Onalaska, WI 54650-8540 - Phone
- (608) 779-5780
- Fax
- (608) 406-3496
- NPI assigned
- Jun 6, 2011
- Last updated
- Apr 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051293610 | IL | |
| Pharmacist | 183500000X | 15328-40 | WI | Primary |
| Pharmacist | 183500000X | 20847 | IA |
Addresses
Primary practice location
9400 State Road 16
Target Pharmacy
Onalaska, WI 54650-8540
Mailing address
9400 State Road 16
Target Pharmacy
Onalaska, WI 54650-8540
Phone (608) 779-5780
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 |
|---|---|---|---|
| 20847 | IA | MD | Pharmacist |
| 051293610 | IL | MD | Pharmacist |
| 15328-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wisconsin CVS Pharmacy LLC | Past | Accepting new patients | |
| Wisconsin CVS Pharmacy LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396742400000",
"number": "1265726368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9400 STATE ROAD 16",
"address_2": "TARGET PHARMACY",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508540",
"telephone_number": "608-779-5780",
"fax_number": "608-406-3496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 STATE ROAD 16",
"address_2": "TARGET PHARMACY",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508540",
"telephone_number": "608-779-5780",
"fax_number": "608-406-3496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATZ",
"first_name": "ADAM",
"middle_name": "DAVID",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-06",
"last_updated": "2014-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051293610",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "15328-40",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20847",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
- Maplewood Dental
- Tiffany Jean Marinier, D.O.
- Courtney Marie Marten, RDH, OMT
- Kelsey Ann Martin, LCSW, CSAC, ICS
- Rebecca Lynn Mattie, OTR/L
- Steven Allen Mayer, RPH
- Mayo Clinic Health System-Southwest Wisconsin Region, Inc. (Onalaska Pharmacy)
- Mayo Clinic Hospital-Rochester
- Mayo Foundation for Medical Education & Research (Mayo Clinic Store - Onalaska)
- Donna McBride, BCTMB
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.