Rose Annette Van Dyke

Primary specialty

PharmacistTaxonomy code 183500000X

License

003887720 Issued in WI

Practice address

3649 S Hastings Way
T-1774
Eau Claire, WI 54701-8182

Phone

(715) 838-0447

NPI assigned

Jul 6, 2011

Last updated

Jul 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1356638795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 S HASTINGS WAY",
            "address_2": "T-1774",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018182",
            "telephone_number": "715-838-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3649 S HASTINGS WAY",
            "address_2": "T-1774",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018182",
            "telephone_number": "715-838-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "ROSE",
        "middle_name": "ANNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "003887720",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202207230",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051039400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David John Usher, MD
• Mithaq Vahedi, M.D.
• Vaibhav R. Vaidya, MBBS
• Kara Nicole Van Beek
• Joann Van Dyk-Adams, RPH
• Jennifer L Van Sleet, MA, PCT
• Tanya J Vanasse, D.C.
• Kristin Anne Vande Hei, DPT
• Victoria Lynn Vande Zande, MD
• David Vandeloo, MD

• Pharmacist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.