Active NPI
Amanda Lea Wegenka, PHARMD
- Pharmacist
- La Crosse, WI
National Provider Identifier
1346575503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15643-40
- Practice address
- 1900 South Ave
H01-005
La Crosse, WI 54601-5467 - Phone
- (608) 775-3701
- NPI assigned
- Oct 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 119551 | MN | |
| Pharmacist | 183500000X | 20886 | IA | |
| Pharmacist | 183500000X | 15643-40 | WI | Primary |
Addresses
Primary practice location
1900 South Ave
H01-005
La Crosse, WI 54601-5467
Mailing address
1836 South Ave # H01-005
La Crosse, WI 54601-5429
Phone (608) 782-7300
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 |
|---|---|---|---|
| 20886 | IA | MD | Pharmacist |
| 119551 | MN | MD | Pharmacist |
| 15643-40 | WI | MD | Pharmacist |
Interoperability endpoints
- awegenka15379@direct.emplifyhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1346575503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE # H01-005",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 SOUTH AVE",
"address_2": "H01-005",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015467",
"telephone_number": "608-775-3701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGENKA",
"first_name": "AMANDA",
"middle_name": "LEA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-06",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "119551",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20886",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "15643-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.