Individual provider Active NPI

Cynthia Eileen Liebau, RPH

  • Pharmacist
  • Madison, WI
National Provider Identifier
1740625862
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11213-40 Issued in WI
Practice address
3801 E Washington Ave
Madison, WI 53704-3648
Phone
(608) 244-4991
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11213-40 WI Primary

Addresses

Primary practice location

3801 E Washington Ave
Madison, WI 53704-3648

Mailing address

3801 E Washington Ave
Madison, WI 53704-3648
Phone (608) 244-4991

Other practice location 1

675 S Whitney Way
Madison, WI 53711-1034
Phone (608) 277-6731

Other practice location 2

2920 Fitchrona Rd
Fitchburg, WI 53719-1802
Phone (608) 273-5122

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
11213-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1740625862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043648",
            "telephone_number": "608-244-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043648",
            "telephone_number": "608-244-4991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 S Whitney Way",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537111034",
            "country_code": "US",
            "telephone_number": "608-277-6731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2920 Fitchrona Rd",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "WI",
            "postal_code": "537191802",
            "country_code": "US",
            "telephone_number": "608-273-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBAU",
        "first_name": "CYNTHIA",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11213-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.