Individual provider Active NPI

Timothy Dreier, RPH

  • Pharmacist
  • Shawano, WI
National Provider Identifier
1366043325
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11385-40 Issued in WI
Practice address
117 S Main St
Shawano, WI 54166-2357
Phone
(715) 526-2011
Fax
(715) 524-6377
NPI assigned
Nov 5, 2020
Last updated
Nov 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11385-40 WI Primary

Addresses

Primary practice location

117 S Main St
Shawano, WI 54166-2357

Mailing address

117 S Main St
Shawano, WI 54166-2357
Phone (715) 526-2011

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://stores.healthmart.com/dreierpharmacy Direct

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
11385-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dreier Pharmacy and Gift Shop Inc Current Accepting new patients
Dreier Pharmacy and Gift Shop Inc Pharmacist Current Accepting new patients

Locations

117 S Main St
Shawano, WI 54166
Phone (715) 524-3331

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1366043325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S MAIN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662357",
            "telephone_number": "715-526-2011",
            "fax_number": "715-524-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S MAIN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662357",
            "telephone_number": "715-526-2011",
            "fax_number": "715-524-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREIER",
        "first_name": "TIMOTHY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11385-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://stores.healthmart.com/dreierpharmacy",
            "affiliation": "N",
            "endpointDescription": "Store webite used to let us know when refill are ready",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "117 S Main St",
            "city": "Shawano",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541662357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.