Active NPI
Kevin L. Schultz, PHARM D.
- Pharmacist
- Menasha, WI
National Provider Identifier
1689010563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13436-40
- Practice address
- 1578 Appleton Rd
Menasha, WI 54952-1104 - Phone
- (920) 722-1895
- Fax
- (920) 722-3195
- NPI assigned
- May 17, 2013
- 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 | 13436-40 | WI | Primary |
Addresses
Primary practice location
1578 Appleton Rd
Menasha, WI 54952-1104
Mailing address
1578 Appleton Rd
Menasha, WI 54952-1104
Phone (920) 722-1895
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 |
|---|---|---|---|
| 13436-40 | WI | 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
- Menasha, WI
- NPI 1508812959
-
- 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": "1368748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1689010563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1578 APPLETON RD",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521104",
"telephone_number": "920-722-1895",
"fax_number": "920-722-3195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1578 APPLETON RD",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521104",
"telephone_number": "920-722-1895",
"fax_number": "920-722-3195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "KEVIN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-17",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13436-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.