Trevor William Breisch, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

17972-40 Issued in WI

Practice address

4602 Eastpark Blvd
Madison, WI 53718-2002

Phone

(608) 440-6360

NPI assigned

Jul 6, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1306229661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STONE CREST RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535894279",
            "telephone_number": "608-845-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 EASTPARK BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182002",
            "telephone_number": "608-440-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREISCH",
        "first_name": "TREVOR",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17972-40",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "17972-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greta Marie Breckbill, AUD
• Stacy Brecke, DPT
• Alan L Breed, MD
• Adam Philip Bregman, M.D., M.B.A
• Serena Breining, MSW, CAPSW
• Kerry Breit, PA-C, MPH
• Thomas Carl Breitbach, MFT
• Sara Pire Breitbarth
• Eileen J Breitweiser, MSW
• Anna Elizabeth Bremer, PHARMD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Madison, WI
• Providers in Madison, WI by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.