Individual provider Active NPI

Emma Jo Olig, PHARMD

  • Pharmacist
  • Plymouth, WI
National Provider Identifier
1689207227
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19145-40 Issued in WI
Practice address
2455 Eastern Ave
Plymouth, WI 53073-4240
Phone
(920) 893-5895
Fax
(920) 893-5898
NPI assigned
Feb 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19145-40 WI Primary

Addresses

Primary practice location

2455 Eastern Ave
Plymouth, WI 53073-4240

Mailing address

2455 Eastern Ave
Plymouth, WI 53073-4240

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

LicenseStateTypeSpecialty
19145-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Sep 15, 2024 Accepting new patients
Walgreen Co PastSince Feb 23, 2020 Accepting new patients

Locations

2455 Eastern Ave
Plymouth, WI 53073
Phone (920) 893-5895

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.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1689207227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530734240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530734240",
            "telephone_number": "920-893-5895",
            "fax_number": "920-893-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIG",
        "first_name": "EMMA",
        "middle_name": "JO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19145-40",
            "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 Feb 21, 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.

Verify at the official NPI Registry.