Active NPI
Mark Molter
- Pharmacist
- Tomah, WI
National Provider Identifier
1518587104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P0018X
- Practice address
- 701 E Clifton St
Tomah, WI 54660-2633 - Phone
- (608) 372-5355
- NPI assigned
- Apr 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P0018X | WI | Primary |
Addresses
Primary practice location
701 E Clifton St
Tomah, WI 54660-2633
Mailing address
701 E Clifton St
Tomah, WI 54660-2633
Phone (608) 372-5355
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Tomah | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| P0018X | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molter Family Pharmacy LLC | Current | Accepting new patients | |
| County of Monroe | Past | Accepting new patients |
Locations
701 E Clifton St
Tomah, WI 54660
Phone (608) 372-4115
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.
-
dba Rolling Hills Rehabilitation Center
- Skilled Nursing Facility
- Sparta, WI
- NPI 1952306748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587600000000",
"number": "1518587104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 E CLIFTON ST",
"city": "TOMAH",
"state": "WI",
"postal_code": "546602633",
"telephone_number": "608-372-5355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E CLIFTON ST",
"city": "TOMAH",
"state": "WI",
"postal_code": "546602633",
"telephone_number": "608-372-5355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLTER",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-23",
"last_updated": "2020-04-23",
"certification_date": "2020-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "P0018X",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Tomah",
"affiliation": "N",
"endpointDescription": "Physical Location",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "701 E Clifton St",
"city": "Tomah",
"state": "WI",
"country_code": "US",
"postal_code": "546602633",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tomah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.