Active NPI
Elizabeth Ketterling
- Pharmacist
- Buffalo, WY
National Provider Identifier
1669772091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3381
- Practice address
- 129 Harmony St
Buffalo, WY 82834-2463 - Phone
- (307) 684-4540
- NPI assigned
- Nov 2, 2010
- 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 | 3381 | WY | Primary |
Addresses
Primary practice location
129 Harmony St
Buffalo, WY 82834-2463
Mailing address
129 Harmony St
Buffalo, WY 82834-2463
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 |
|---|---|---|---|
| 3381 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shopko Stores Operating Co LLC | Past | Accepting new patients | |
| Shopko Stores Operating Co. LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Buffalo, WY
- NPI 1780936963
-
- Eyewear Supplier
- Albert Lea, MN
- NPI 1528010642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1669772091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 HARMONY ST",
"city": "BUFFALO",
"state": "WY",
"postal_code": "828342463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 HARMONY ST",
"city": "BUFFALO",
"state": "WY",
"postal_code": "828342463",
"telephone_number": "307-684-4540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTERLING",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-02",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.