Active NPI
Sara Kornowske, PHARMD
- Pharmacist
- Green Bay, WI
National Provider Identifier
1689483281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17124-40
- Practice address
- 2222 S Webster Ave
Green Bay, WI 54301-2100 - Phone
- (920) 430-8089
- NPI assigned
- Jan 7, 2025
- 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 | 17124-40 | WI | Primary |
Addresses
Primary practice location
2222 S Webster Ave
Green Bay, WI 54301-2100
Mailing address
1593 Rustic Way
Green Bay, WI 54313-6185
Phone (920) 327-0477
Other names 1
- Sara Peeters
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 |
|---|---|---|---|
| 17124-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wisconsin CVS Pharmacy LLC | Past | Accepting new patients | |
| Wisconsin CVS Pharmacy 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1689483281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1593 RUSTIC WAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543136185",
"telephone_number": "920-327-0477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012100",
"telephone_number": "920-430-8089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNOWSKE",
"first_name": "SARA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-07",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17124-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "PEETERS",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.