Individual provider Active NPI

Margaret Jean Wiesner, PHARMD

  • Pharmacist
  • Racine, WI
National Provider Identifier
1487930343
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11649 Issued in WI
Practice address
5005 Douglas Ave
Racine, WI 53402-2027
Phone
(262) 639-9241
Fax
(262) 639-0840
NPI assigned
Oct 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11649 WI Primary
Pharmacist 183500000X 11649-040 WI

Addresses

Primary practice location

5005 Douglas Ave
Racine, WI 53402-2027

Mailing address

5005 Douglas Ave
Racine, WI 53402-2027
Phone (262) 639-9241

Other practice location 1

4810 Washington Ave
Racine, WI 53406-4220
Phone (262) 635-0181

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
11649WIMDPharmacist
11649-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jun 16, 2024 Accepting new patients
Walgreen Co PastSince Jan 1, 2023 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": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1487930343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 DOUGLAS AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534022027",
            "telephone_number": "262-639-9241",
            "fax_number": "262-639-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 DOUGLAS AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534022027",
            "telephone_number": "262-639-9241",
            "fax_number": "262-639-0840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4810 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "534064220",
            "country_code": "US",
            "telephone_number": "262-635-0181",
            "fax_number": "262-635-1865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESNER",
        "first_name": "MARGARET",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11649",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11649-040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; 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.