NPIMap

Individual provider Active NPI

Trevor Holwell, PHARMD

  • Pharmacist
  • Grafton, WI
National Provider Identifier
1467708446
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051295836 Issued in IL
Practice address
1600 N Port Washington Rd
Grafton, WI 53024
Phone
(262) 204-2810
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051295836 IL Primary

Addresses

Primary practice location

1600 N Port Washington Rd
Grafton, WI 53024

Mailing address

1600 N Port Washington Rd
Grafton, WI 53024
Phone (262) 204-2810

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051295836ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meijer Stores Limited Partnership Past Accepting new patients
Meijer Stores Limited Partnership 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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1467708446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "53024",
            "telephone_number": "262-204-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "53024",
            "telephone_number": "262-204-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLWELL",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.