Individual provider Active NPI

Steven J Suokko, PHARMACIST

  • Pharmacist
  • Racine, WI
National Provider Identifier
1457503195
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13922-040 Issued in WI
Practice address
1320 Wisconsin Ave
Pain Management Clinic
Racine, WI 53403-1978
Phone
(262) 687-2635
NPI assigned
Oct 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13922-040 WI Primary

Addresses

Primary practice location

1320 Wisconsin Ave
Pain Management Clinic
Racine, WI 53403-1978

Mailing address

3801 Spring St
Pharmacy Department
Racine, WI 53405-1667
Phone (262) 687-4308

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
13922-040WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1457503195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SPRING ST",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "address_2": "PAIN MANAGEMENT CLINIC",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUOKKO",
        "first_name": "STEVEN",
        "middle_name": "J",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13922-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.