NPIMap

Individual provider Active NPI

Carianne Pace, PHARMD

  • Pharmacist
  • Green Bay, WI
National Provider Identifier
1609158971
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17742-40 Issued in WI
Practice address
116 N Military Ave
Green Bay, WI 54303-3202
Phone
(920) 498-3247
Fax
(920) 498-3387
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17742-40 WI Primary
Pharmacist 183500000X 051.290928 IL

Addresses

Primary practice location

116 N Military Ave
Green Bay, WI 54303-3202

Mailing address

116 N Military Ave
Green Bay, WI 54303-3202
Phone (920) 498-3247

Other practice location 1

4001 w irving park rd
chicago, IL 60641-2926
Phone (773) 685-3527

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rxm.11339@store.walgreens.com Direct

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
051.290928ILMDPharmacist
17742-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jul 1, 2020 Accepting new patients
Walgreen Co PastSince Mar 1, 2020 Accepting new patients
Walgreen Co Past Accepting new patients

Locations

116 N Military Ave
Green Bay, WI 54303
Phone (920) 498-3247

Organizations & group practices 3

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1609158971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N MILITARY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033202",
            "telephone_number": "920-498-3247",
            "fax_number": "920-498-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N MILITARY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033202",
            "telephone_number": "920-498-3247",
            "fax_number": "920-498-3387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 w irving park rd",
            "address_purpose": "LOCATION",
            "city": "chicago",
            "state": "IL",
            "postal_code": "606412926",
            "country_code": "US",
            "telephone_number": "773-685-3527",
            "fax_number": "773-685-4554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "CARIANNE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17742-40",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.290928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.11339@store.walgreens.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "116 N Military Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543033202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.