Active NPI
Roger Alan Smith Jr., PHARMD
- Pharmacist
- Wales, WI
National Provider Identifier
1629602289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18665-40
- Practice address
- 320 W Summit Ave
Wales, WI 53183-9436 - Phone
- (262) 968-6900
- Fax
- (262) 968-3714
- NPI assigned
- Feb 23, 2020
- Last updated
- Feb 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18665-40 | WI | Primary |
Addresses
Primary practice location
320 W Summit Ave
Wales, WI 53183-9436
Mailing address
320 W Summit Ave
Wales, WI 53183-9436
Phone (262) 968-6900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18665-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
320 W Summit Ave
Wales, WI 53183
Phone (262) 968-6900
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582416000000",
"number": "1629602289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 W SUMMIT AVE",
"city": "WALES",
"state": "WI",
"postal_code": "531839436",
"telephone_number": "262-968-6900",
"fax_number": "262-968-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 W SUMMIT AVE",
"city": "WALES",
"state": "WI",
"postal_code": "531839436",
"telephone_number": "262-968-6900",
"fax_number": "262-968-3714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ROGER",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-23",
"last_updated": "2020-02-23",
"certification_date": "2020-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18665-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wales, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.