Individual provider Active NPI

Wendy Ludtke

  • Pharmacist
  • Plover, WI
National Provider Identifier
1457950651
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16270-40 Issued in WI
Practice address
250 Crossroads Dr
Plover, WI 54467-4124
Phone
(715) 345-7870
Fax
(715) 345-2698
NPI assigned
Oct 20, 2020
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16270-40 WI Primary

Addresses

Primary practice location

250 Crossroads Dr
Plover, WI 54467-4124

Mailing address

250 Crossroads Dr
Plover, WI 54467-4124
Phone (715) 345-7870

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
16270-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1457950651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CROSSROADS DR",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544674124",
            "telephone_number": "715-345-7870",
            "fax_number": "715-345-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CROSSROADS DR",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544674124",
            "telephone_number": "715-345-7870",
            "fax_number": "715-345-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDTKE",
        "first_name": "WENDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "16270-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plover, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.