Individual provider Active NPI

Taylor Lee Watterson, PHARMD

  • Pharmacist
  • Fitchburg, WI
National Provider Identifier
1609385202
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19052-40 Issued in WI
Practice address
3000 Cahill Main # 114
Fitchburg, WI 53711-7132
Phone
(608) 274-3784
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19052-40 WI Primary

Addresses

Primary practice location

3000 Cahill Main # 114
Fitchburg, WI 53711-7132

Mailing address

4723 Sheboygan Ave Apt 111
Madison, WI 53705-3145
Phone (724) 875-0020

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
19052-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitchburg Family Pharmacy LLC Past Accepting new patients

Organizations & group practices 1

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1609385202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 SHEBOYGAN AVE APT 111",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053145",
            "telephone_number": "724-875-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CAHILL MAIN # 114",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117132",
            "telephone_number": "608-274-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERSON",
        "first_name": "TAYLOR",
        "middle_name": "LEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19052-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.