Active NPI
Daniel Rebholz
- Pharmacist
- Plover, WI
National Provider Identifier
1487044079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13222-40
- Practice address
- 1800 Plover Rd
Plover, WI 54467-3978 - Phone
- (715) 342-9368
- NPI assigned
- Feb 3, 2015
- Last updated
- Feb 3, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13222-40 | WI | Primary |
| Pharmacist | 183500000X | 051.286252 | IL |
Addresses
Primary practice location
1800 Plover Rd
Plover, WI 54467-3978
Mailing address
1800 Plover Rd
Plover, WI 54467-3978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051.286252 | IL | MD | Pharmacist |
| 13222-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1487044079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 PLOVER RD",
"city": "PLOVER",
"state": "WI",
"postal_code": "544673978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 PLOVER RD",
"city": "PLOVER",
"state": "WI",
"postal_code": "544673978",
"telephone_number": "715-342-9368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBHOLZ",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-03",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13222-40",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.286252",
"primary": false
}
],
"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 Feb 3, 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.