Active NPI
Marcus Pribyl
- Pharmacist
- Monroe, WI
National Provider Identifier
1700518586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21292-40
- Practice address
- 515 22ND Ave
Monroe, WI 53566-1598 - Phone
- (920) 419-0434
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 21292-40 | WI | Primary |
Addresses
Primary practice location
515 22ND Ave
Monroe, WI 53566-1598
Mailing address
224 3Rd Ave Apt 3
Monroe, WI 53566-3740
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 |
|---|---|---|---|
| 21292-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1700518586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 3RD AVE APT 3",
"city": "MONROE",
"state": "WI",
"postal_code": "535663740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661598",
"telephone_number": "920-419-0434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIBYL",
"first_name": "MARCUS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "21292-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.