Individual provider Active NPI

Louise A Borst, RPH CGP

  • Pharmacist
  • Kenosha, WI
National Provider Identifier
1396147625
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12571-040 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-5680
Fax
(262) 948-5681
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12571-040 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

12039 231St Ave
Trevor, WI 53179-9439
Phone (262) 862-2998

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
12571-040WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1396147625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 231ST AVE",
            "city": "TREVOR",
            "state": "WI",
            "postal_code": "531799439",
            "telephone_number": "262-862-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-5680",
            "fax_number": "262-948-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORST",
        "first_name": "LOUISE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RPH CGP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12571-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.