Active NPI
Matthew Duane Leblanc, PHARMD
- Pharmacist
- Hayward, WI
National Provider Identifier
1750121273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19286-40
- Practice address
- 11040 N State Road 77
Hayward, WI 54843-3606 - Phone
- (715) 934-4230
- Fax
- (715) 934-4278
- NPI assigned
- May 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19286-40 | WI | Primary |
Addresses
Primary practice location
11040 N State Road 77
Hayward, WI 54843-3606
Mailing address
16270 W Granite TRL
Hayward, WI 54843-4584
Phone (715) 558-1984
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)
- Enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19286-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1750121273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16270 W GRANITE TRL",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548434584",
"telephone_number": "715-558-1984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11040 N STATE ROAD 77",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548433606",
"telephone_number": "715-934-4230",
"fax_number": "715-934-4278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBLANC",
"first_name": "MATTHEW",
"middle_name": "DUANE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19286-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.