Individual provider Active NPI

Taylor Millar

  • Pharmacist
  • Green Bay, WI
National Provider Identifier
1750090460
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21483 Issued in WI
Practice address
635 Main St
Green Bay, WI 54301-4918
Phone
(920) 437-0206
Fax
(920) 437-0276
NPI assigned
Nov 21, 2022
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 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 21483 WI Primary

Addresses

Primary practice location

635 Main St
Green Bay, WI 54301-4918

Mailing address

2895 Madrid Dr
Green Bay, WI 54311-6620
Phone (920) 544-1213

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

State licenses

LicenseStateTypeSpecialty
21483WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1750090460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2895 MADRID DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116620",
            "telephone_number": "920-544-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014918",
            "telephone_number": "920-437-0206",
            "fax_number": "920-437-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAR",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.