David Haynes Betts III, PHARM.D.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

19547-40 Issued in WI

Practice address

2470 W Mason St
Green Bay, WI 54303-4711

Phone

(920) 494-0536

Fax

(920) 494-1131

NPI assigned

Feb 26, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1740814987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 MEMORIAL DR APT 105",
            "city": "HOWARD",
            "state": "WI",
            "postal_code": "543031291",
            "telephone_number": "847-848-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543034711",
            "telephone_number": "920-494-0536",
            "fax_number": "920-494-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTS",
        "first_name": "DAVID",
        "middle_name": "HAYNES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "19547-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "d0b01zu.s08149.us@samsclub.com",
            "affiliation": "N",
            "endpointDescription": "work e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2470 W Mason St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543034711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Besiada Health Innovators, LLC
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• Samantha Bestul, OD
• Thomas C Betka, M.D.
• Ryan Mathew Betley, APSW
• Terry Sue Betts, PTA
• Heather Jean Bevers, DNP, APNP, FNP-C
• James R Beversdorf, LAT, CSCS, PES
• Richard Lawrence Beyer, BC HIS
• Jennifer Rae Beyette

• Community/Retail Pharmacy in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Community/Retail Pharmacy in Wisconsin

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