Benjamin Isaac Niebaum, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

15998-040 Issued in WI

Practice address

1106 W Clairemont Ave
Eau Claire, WI 54701-6124

Phone

(715) 852-0063

NPI assigned

Oct 26, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Eau Claire, WI
  • NPI 1588671531
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1730465345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 RIDGEVIEW DR",
            "address_2": "APT. 302",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017853",
            "telephone_number": "763-242-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016124",
            "telephone_number": "715-852-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBAUM",
        "first_name": "BENJAMIN",
        "middle_name": "ISAAC",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15998-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Patric Neyens, O.D.
• Joy G Ngobi, MD
• Thao H Nguyen, FNP-C
• Marisa Ann Nichols, PHARM.D.
• Mattie Lynne Nicholson, CSW
• Carly Carolyn Nielsen, CCC-SLP
• Martha E Nieman, CNM
• Eric R Niendorf, MD
• Amy Lynn Nikolai, PA-C
• Melissa A Nissen, MD

• Pharmacist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.