Individual provider Active NPI

Marion Kaye-Marquardt

  • Pharmacist
  • Manitowoc, WI
National Provider Identifier
1508064643
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9970-040 Issued in WI
Practice address
2702 Calumet Ave
Manitowoc, WI 54220-5547
Phone
(920) 683-8887
Fax
(920) 683-1216
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9970-040 WI Primary

Addresses

Primary practice location

2702 Calumet Ave
Manitowoc, WI 54220-5547

Mailing address

2702 Calumet Ave
Manitowoc, WI 54220-5547
Phone (920) 683-8887

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

LicenseStateTypeSpecialty
9970-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jun 16, 2024 Accepting new patients
Walgreen Co 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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1508064643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 CALUMET AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205547",
            "telephone_number": "920-683-8887",
            "fax_number": "920-683-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 CALUMET AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205547",
            "telephone_number": "920-683-8887",
            "fax_number": "920-683-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE-MARQUARDT",
        "first_name": "MARION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "9970-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.