Individual provider Active NPI

Brian L Gaul, PHARMD

  • Pharmacist
  • Tomah, WI
National Provider Identifier
1417009226
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16983 Issued in WI
Practice address
701 E Clifton St
Tomah, WI 54660-2633
Phone
(608) 372-4115
Fax
(608) 372-9626
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19600 IA
Pharmacist 183500000X 16983 WI Primary

Addresses

Primary practice location

701 E Clifton St
Tomah, WI 54660-2633

Mailing address

701 E Clifton St
Tomah, WI 54660-2633

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
19600IAMDPharmacist
16983WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Molter Family Pharmacy LLC CurrentSince Feb 19, 2023 Accepting new patients
Prescription Shoppe, Inc. Past Accepting new patients
County of Monroe PastSince Feb 19, 2023 Accepting new patients

Locations

701 E Clifton St
Tomah, WI 54660
Phone (608) 372-4115

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1417009226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E CLIFTON ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546602633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CLIFTON ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546602633",
            "telephone_number": "608-372-4115",
            "fax_number": "608-372-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUL",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-02-17",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "19600",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "16983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.