Individual provider Active NPI

Wallace L Gehring, RPH

  • Pharmacist
  • Wisconsin Rapids, WI
National Provider Identifier
1457637738
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8450-40 Issued in WI
Practice address
3200 8TH St S
Wisconsin Rapids, WI 54494-6563
Phone
(715) 424-4082
NPI assigned
Oct 31, 2011
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8450-40 WI Primary

Addresses

Primary practice location

3200 8TH St S
Wisconsin Rapids, WI 54494-6563

Mailing address

W3396 Duck Creek Ave
Montello, WI 53949-8431
Phone (920) 293-8787

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8450-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients

Organizations & group practices 1

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": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1457637738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3396 DUCK CREEK AVE",
            "city": "MONTELLO",
            "state": "WI",
            "postal_code": "539498431",
            "telephone_number": "920-293-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 8TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946563",
            "telephone_number": "715-424-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHRING",
        "first_name": "WALLACE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "8450-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.