Individual provider Active NPI

Katherine Fiacchino

  • Pharmacist
  • Menomonee Falls, WI
National Provider Identifier
1285036822
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17727-40 Issued in WI
Practice address
N95W17707 Shady LN
Menomonee Falls, WI 53051-8012
Phone
(262) 415-0005
NPI assigned
Sep 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17727-40 WI Primary

Addresses

Primary practice location

N95W17707 Shady LN
Menomonee Falls, WI 53051-8012

Mailing address

N95W17707 Shady LN
Menomonee Falls, WI 53051-8012
Phone (262) 415-0005

Other identifiers 1

IdentifierTypeStateIssuer
3327560MedicaidWI

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

LicenseStateTypeSpecialty
17727-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1285036822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N95W17707 SHADY LN",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518012",
            "telephone_number": "262-415-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N95W17707 SHADY LN",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530518012",
            "telephone_number": "262-415-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIACCHINO",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17727-40",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3327560",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.

Verify at the official NPI Registry.