NPIMap

Individual provider Active NPI

Camala Jorstad, R.PH.

  • Pharmacist
  • Sheboygan, WI
National Provider Identifier
1457765398
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15393-40 Issued in WI
Practice address
577 S Taylor Dr
Sheboygan, WI 53081-4234
Phone
(920) 459-7467
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15393-40 WI Primary

Addresses

Primary practice location

577 S Taylor Dr
Sheboygan, WI 53081-4234

Mailing address

W4855 Hickory Hills Rd
Chilton, WI 53014-9724
Phone (920) 254-7270

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
15393-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiling Dog Investments Inc Past Accepting new patients
Hayat Pharmacy 17, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1457765398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W4855 HICKORY HILLS RD",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530149724",
            "telephone_number": "920-254-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 S TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814234",
            "telephone_number": "920-459-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORSTAD",
        "first_name": "CAMALA",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15393-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.