Active NPI
Mark Miller
- Pharmacist
- Reedsburg, WI
National Provider Identifier
1306714712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22765-40
- Practice address
- 2000 N Dewey Ave
Reedsburg, WI 53959-1049 - Phone
- (608) 524-6487
- NPI assigned
- Oct 27, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22765-40 | WI | Primary |
Addresses
Primary practice location
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Mailing address
4827 Suelo Rd Unit 102
Fitchburg, WI 53711-9601
Phone (715) 808-3058
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 |
|---|---|---|---|
| 22765-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1306714712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4827 SUELO RD UNIT 102",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537119601",
"telephone_number": "715-808-3058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N DEWEY AVE",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591049",
"telephone_number": "608-524-6487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-27",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "22765-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reedsburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.