Individual provider Active NPI

Semra Lisa Johnson, RPH

  • Pharmacist
  • Minocqua, WI
National Provider Identifier
1609474121
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11512 Issued in WI
Practice address
8760 Northridge Way
Minocqua, WI 54548-8766
Phone
(715) 356-3782
Fax
(715) 356-4883
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 11512 WI Primary

Addresses

Primary practice location

8760 Northridge Way
Minocqua, WI 54548-8766

Mailing address

1960 N Farming Rd
Arbor Vitae, WI 54568-9582
Phone (715) 614-6206

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
Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1609474121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 N FARMING RD",
            "city": "ARBOR VITAE",
            "state": "WI",
            "postal_code": "545689582",
            "telephone_number": "715-614-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8760 NORTHRIDGE WAY",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545488766",
            "telephone_number": "715-356-3782",
            "fax_number": "715-356-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SEMRA",
        "middle_name": "LISA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.