Individual provider Active NPI

Katelyn Piddington, PHARMD

  • Pharmacist
  • Stoughton, WI
National Provider Identifier
1407589963
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21310-40 Issued in WI
Practice address
1705 US Highway 51 and 138
Stoughton, WI 53589-1907
Phone
(608) 873-7612
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21310-40 WI Primary

Addresses

Primary practice location

1705 US Highway 51 and 138
Stoughton, WI 53589-1907

Mailing address

1705 US Highway 51 and 138
Stoughton, WI 53589-1907
Phone (608) 873-7612

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

LicenseStateTypeSpecialty
21310-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 24, 2024 Accepting new patients
Walgreen Co PastSince Jul 1, 2022 Accepting new patients
Walgreen Co PastSince Jun 16, 2024 Accepting new patients

Locations

1705 US Highway 51 and 138
Stoughton, WI 53589
Phone (608) 773-7612

Organizations & group practices 3

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1407589963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 US HIGHWAY 51 AND 138",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891907",
            "telephone_number": "608-873-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 US HIGHWAY 51 AND 138",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891907",
            "telephone_number": "608-873-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIDDINGTON",
        "first_name": "KATELYN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21310-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

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

Verify at the official NPI Registry.