Individual provider Active NPI

John Rydman, PHARMD

  • Pharmacist
  • Muskego, WI
National Provider Identifier
1528669991
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19131-40 Issued in WI
Practice address
W159S6530 Moorland Rd
Muskego, WI 53150-7515
Phone
(414) 209-0324
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19131-40 WI Primary

Addresses

Primary practice location

W159S6530 Moorland Rd
Muskego, WI 53150-7515

Mailing address

W159S6530 Moorland Rd
Muskego, WI 53150-7515
Phone (414) 209-0324

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
19131-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1528669991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W159S6530 MOORLAND RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507515",
            "telephone_number": "414-209-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W159S6530 MOORLAND RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531507515",
            "telephone_number": "414-209-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDMAN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19131-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.