Active NPI
Madison Stanczak
- Pharmacist
- Plymouth, WI
National Provider Identifier
1639898257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21402
- Practice address
- 428 Walton Dr
Plymouth, WI 53073-5019 - Phone
- (920) 892-7523
- NPI assigned
- Aug 25, 2022
- Last updated
- Aug 25, 2022
- Sex
- Female
- 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 | 21402 | WI | Primary |
Addresses
Primary practice location
428 Walton Dr
Plymouth, WI 53073-5019
Mailing address
547 N Dries St
Saukville, WI 53080-1707
Phone (262) 949-9649
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21402 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1639898257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "547 N DRIES ST",
"city": "SAUKVILLE",
"state": "WI",
"postal_code": "530801707",
"telephone_number": "262-949-9649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 WALTON DR",
"city": "PLYMOUTH",
"state": "WI",
"postal_code": "530735019",
"telephone_number": "920-892-7523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANCZAK",
"first_name": "MADISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "21402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.