Active NPI
Amy M Derenne, PHARMD
- Pharmacist
- Cashton, WI
National Provider Identifier
1336773167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19892-40
- Practice address
- 238 Front St
Cashton, WI 54619-2002 - Phone
- (608) 654-5100
- Fax
- (608) 654-5120
- NPI assigned
- Mar 2, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 19892-40 | WI | Primary |
Addresses
Primary practice location
238 Front St
Cashton, WI 54619-2002
Mailing address
238 Front St
Cashton, WI 54619-2002
Phone (608) 654-5100
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19892-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1336773167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 FRONT ST",
"city": "CASHTON",
"state": "WI",
"postal_code": "546192002",
"telephone_number": "608-654-5100",
"fax_number": "605-654-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 FRONT ST",
"city": "CASHTON",
"state": "WI",
"postal_code": "546192002",
"telephone_number": "608-654-5100",
"fax_number": "608-654-5120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERENNE",
"first_name": "AMY",
"middle_name": "M",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19892-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cashton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.