Individual provider Active NPI

Stephen Ernest Paquin, RPH

  • Pharmacist
  • Oconomowoc, WI
National Provider Identifier
1477990323
Registry record updated Jun 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10429-40 Issued in WI
Practice address
36596 Upper Cape CT
Oconomowoc, WI 53066-9478
Phone
(262) 244-1234
NPI assigned
Jun 2, 2013
Last updated
Jun 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 112454 MN
Pharmacist 183500000X 10429-40 WI Primary
Pharmacist 183500000X 3433 ND

Addresses

Primary practice location

36596 Upper Cape CT
Oconomowoc, WI 53066-9478

Mailing address

36596 Upper Cape CT
Oconomowoc, WI 53066-9478
Phone (262) 244-1234

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
112454MNMDPharmacist
3433NDMDPharmacist
10429-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370131200000",
    "number": "1477990323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36596 UPPER CAPE CT",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530669478",
            "telephone_number": "262-244-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36596 UPPER CAPE CT",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530669478",
            "telephone_number": "262-244-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUIN",
        "first_name": "STEPHEN",
        "middle_name": "ERNEST",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-02",
        "last_updated": "2013-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "112454",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "10429-40",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "3433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2013; 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.