Individual provider Active NPI

Joel Lee Kaczinski

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Mukwonago, WI
National Provider Identifier
1336369115
Registry record updated May 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
12879-40 Issued in WI
Practice address
W327S8163 Memory LN
Mukwonago, WI 53149-8606
Phone
(262) 363-3939
NPI assigned
Apr 26, 2007
Last updated
May 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 12879-40 WI Primary

Addresses

Primary practice location

W327S8163 Memory LN
Mukwonago, WI 53149-8606

Mailing address

W327S8163 Memory LN
Mukwonago, WI 53149-8606
Phone (262) 363-3939

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
12879-40WIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779494400000",
    "number": "1336369115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W327S8163 MEMORY LN",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498606",
            "telephone_number": "262-363-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W327S8163 MEMORY LN",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531498606",
            "telephone_number": "262-363-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZINSKI",
        "first_name": "JOEL",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2026-05-23",
        "certification_date": "2026-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "12879-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukwonago, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2026; 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.