Individual provider Active NPI

Elizabeth Williamschen

  • Pharmacist
  • Wadena, MN
National Provider Identifier
1437644275
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
41-0907427 Issued in MN
Practice address
321 Jefferson St N
Wadena, MN 56482-1372
Phone
(218) 631-4050
Fax
(218) 631-2726
NPI assigned
Jun 25, 2018
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 41-0907427 MN Primary

Addresses

Primary practice location

321 Jefferson St N
Wadena, MN 56482-1372

Mailing address

321 Jefferson St N
Wadena, MN 56482-1372
Phone (218) 631-4050

Other identifiers 1

IdentifierTypeStateIssuer
1457652497MedicaidMN

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
41-0907427MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1437644275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821372",
            "telephone_number": "218-631-4050",
            "fax_number": "218-631-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821372",
            "telephone_number": "218-631-4050",
            "fax_number": "218-631-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSCHEN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "41-0907427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457652497",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadena, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.