Active NPI
Martin Wiederkehr, B.S. PHARM
- Pharmacist
- Boca Raton, FL
National Provider Identifier
1316080914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7924
- Practice address
- 6389 Brava Way
Boca Raton, FL 33433-8236 - Phone
- (561) 750-7443
- Fax
- (707) 264-8619
- NPI assigned
- Feb 14, 2007
- 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 | 7924 | FL | Primary |
Addresses
Primary practice location
6389 Brava Way
Boca Raton, FL 33433-8236
Mailing address
6389 Brava Way
Boca Raton, FL 33433-8236
Phone (561) 750-7443
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
- Bachelor of Science, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7924 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316080914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6389 BRAVA WAY",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334338236",
"telephone_number": "561-750-7443",
"fax_number": "707-264-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6389 BRAVA WAY",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334338236",
"telephone_number": "561-750-7443",
"fax_number": "707-264-8619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDERKEHR",
"first_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "B.S. PHARM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "7924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.