Individual provider Active NPI

Michael Jensen

  • Pharmacist
  • Stevens Point, WI
National Provider Identifier
1629469366
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11944-40 Issued in WI
Practice address
1500 Pinecrest Ave
Stevens Point, WI 54481-4326
Phone
(715) 345-7175
Fax
(715) 345-1745
NPI assigned
Feb 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11944-40 WI Primary

Addresses

Primary practice location

1500 Pinecrest Ave
Stevens Point, WI 54481-4326

Mailing address

1500 Pinecrest Ave
Stevens Point, WI 54481-4326
Phone (715) 345-7175

Other names 1

  • Michael Francis Jensen Former name

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

LicenseStateTypeSpecialty
11944-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1629469366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PINECREST AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544814326",
            "telephone_number": "715-345-7175",
            "fax_number": "715-345-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PINECREST AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544814326",
            "telephone_number": "715-345-7175",
            "fax_number": "715-345-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11944-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "JENSEN",
            "middle_name": "FRANCIS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.