Active NPI
Kevin Staral
- Pharmacist
- Wauwatosa, WI
National Provider Identifier
1275017584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19344
- Practice address
- 11111 W Burleigh St
Wauwatosa, WI 53222-3211 - Phone
- (414) 290-0910
- NPI assigned
- Sep 21, 2018
- Sex
- Male
- 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 | 19344 | WI | Primary |
Addresses
Primary practice location
11111 W Burleigh St
Wauwatosa, WI 53222-3211
Mailing address
11111 W Burleigh St
Wauwatosa, WI 53222-3211
Phone (414) 290-0910
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19344-40 | Other | WI | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| 19344 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1275017584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11111 W BURLEIGH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532223211",
"telephone_number": "414-290-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11111 W BURLEIGH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532223211",
"telephone_number": "414-290-0910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARAL",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-21",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19344",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "19344-40",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.