Individual provider Active NPI

Judy L Dumermuth, R.PH.

  • Pharmacist
  • Ellsworth, WI
National Provider Identifier
1740534312
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12401-40 Issued in WI
Practice address
598 Lucas Lane
Ellsworth, WI 54011-0207
Phone
(715) 273-4278
Fax
(715) 273-4326
NPI assigned
Nov 5, 2012
Last updated
Nov 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12401-40 WI Primary

Addresses

Primary practice location

598 Lucas Lane
Ellsworth, WI 54011-0207

Mailing address

598 Lucas Lane
Ellsworth, WI 54011-0207
Phone (715) 273-4278

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
12401-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1740534312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 LUCAS LANE",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540110207",
            "telephone_number": "715-273-4278",
            "fax_number": "715-273-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 LUCAS LANE",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540110207",
            "telephone_number": "715-273-4278",
            "fax_number": "715-273-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMERMUTH",
        "first_name": "JUDY",
        "middle_name": "L",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12401-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.