Kyle Matthew Wayner, PHARMD

Primary specialty

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

License

21021 Issued in WI

Practice address

609 N Spring St
Beaver Dam, WI 53916-2040

Phone

(920) 356-1500

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1336813609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 N SPRING ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162040",
            "telephone_number": "920-356-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 N SPRING ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162040",
            "telephone_number": "920-356-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNER",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "21021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Nicole Walsh, AU.D.
• Alan James Walton, MD
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• Justyce Alexandria Wandersee, APSW
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• Pamela Webb
• Jody Weber, DPT
• Erin Nicole Wentland, APNP
• Sarah West, SAC-IT
• Amanda Grace White, RN

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Beaver Dam, WI
• Providers in Beaver Dam, 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 Aug 2, 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.

Verify at the official NPI Registry.