Individual provider Active NPI

Amber S Kollmar, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Germantown, WI
National Provider Identifier
1710212741
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
15374-40 Issued in WI
Practice address
N112W16200 Mequon Rd
Germantown, WI 53022-3334
Phone
(262) 253-0052
Fax
(855) 772-6251
NPI assigned
Oct 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15374-40 WI
Pharmacist 183500000X 5302035309 MI
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 15374-40 WI Primary

Addresses

Primary practice location

N112W16200 Mequon Rd
Germantown, WI 53022-3334

Mailing address

N112W16200 Mequon Rd
Germantown, WI 53022-3334
Phone (262) 253-0052

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
5302035309MIMDPharmacist
15374-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roundys Supermarkets Inc Past Accepting new patients
Roundys Supermarkets Inc 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": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1710212741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N112W16200 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223334",
            "telephone_number": "262-253-0052",
            "fax_number": "855-772-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N112W16200 MEQUON RD",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223334",
            "telephone_number": "262-253-0052",
            "fax_number": "855-772-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMAR",
        "first_name": "AMBER",
        "middle_name": "S",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15374-40",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302035309",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "15374-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.