Individual provider Active NPI

Mary Alice Letsche, RPH

  • Pharmacist
  • Dubuque, IA
National Provider Identifier
1407485899
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17926 Issued in IA
Practice address
1920 Elm St
Dubuque, IA 52001-3641
Phone
(563) 583-7379
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 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 17926 IA Primary

Addresses

Primary practice location

1920 Elm St
Dubuque, IA 52001-3641

Mailing address

2065 Lagen St
Dubuque, IA 52002-0452
Phone (712) 229-3023

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
17926IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Family Pharmacy PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1407485899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 LAGEN ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520020452",
            "telephone_number": "712-229-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ELM ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013641",
            "telephone_number": "563-583-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETSCHE",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "17926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.