Individual provider Active NPI

Sherry Krueger, RPH

  • Pharmacist
  • Hudson, WI
National Provider Identifier
1699376780
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12239-40 Issued in WI
Practice address
2310 Crest View Dr
Hudson, WI 54016-9315
Phone
(715) 381-5923
Fax
(715) 381-5993
NPI assigned
Nov 4, 2020
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 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 12239-40 WI Primary

Addresses

Primary practice location

2310 Crest View Dr
Hudson, WI 54016-9315

Mailing address

2310 Crest View Dr
Hudson, WI 54016-9315
Phone (715) 381-5923

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
12239-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jerrys Enterprises Inc Current Accepting new patients
Jerrys Enterprises Inc Current Accepting new patients

Locations

2310 Crest View Dr
Hudson, WI 54016
Phone (715) 381-5923

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1699376780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 CREST VIEW DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169315",
            "telephone_number": "715-381-5923",
            "fax_number": "715-381-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CREST VIEW DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169315",
            "telephone_number": "715-381-5923",
            "fax_number": "715-381-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "SHERRY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12239-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.