Jonathan Opheim, RPH

Primary specialty

Clinical Pharmacology PhysicianTaxonomy code 208U00000X

License

19985-40 Issued in WI

Practice address

W9897 Hickory LN
Pickett, WI 54964-9600

Phone

(920) 872-0123

NPI assigned

Oct 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1477197853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W9897 HICKORY LN",
            "city": "PICKETT",
            "state": "WI",
            "postal_code": "549649600",
            "telephone_number": "920-872-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W9897 HICKORY LN",
            "city": "PICKETT",
            "state": "WI",
            "postal_code": "549649600",
            "telephone_number": "920-872-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPHEIM",
        "first_name": "JONATHAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "WI",
            "license": "19985-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pickett",
            "affiliation": "N",
            "address_1": "W9897 Hickory Ln",
            "city": "Pickett",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549649600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary D Butcher, RPH
• Ralph Kalies

• Clinical Pharmacology Physician in Pickett, WI
• Providers in Pickett, WI by specialty
• Clinical Pharmacology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.