NPIMap

Individual provider Active NPI

Rhonda Wine

  • Pharmacist
  • La Crosse, WI
National Provider Identifier
1417393315
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11354-040 Issued in WI
Practice address
2400 Rose St
La Crosse, WI 54603-1612
Phone
(608) 781-3300
Fax
(608) 783-7810
NPI assigned
May 17, 2013
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11354-040 WI Primary

Addresses

Primary practice location

2400 Rose St
La Crosse, WI 54603-1612

Mailing address

2400 Rose St
La Crosse, WI 54603-1612

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

State licenses

LicenseStateTypeSpecialty
11354-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shopko Stores Operating Co. LLC Past Accepting new patients
Shopko Stores Operating Co LLC Past Accepting new patients

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": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1417393315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546031612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546031612",
            "telephone_number": "608-781-3300",
            "fax_number": "608-783-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "RHONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11354-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.