Individual provider Active NPI

John Jerome Zywicke

  • Pharmacist
  • Mequon, WI
National Provider Identifier
1750658563
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7738 Issued in WI
Practice address
9811 N Melrose CT
Mequon, WI 53097-3834
Phone
(262) 242-6388
NPI assigned
Nov 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7738 WI Primary

Addresses

Primary practice location

9811 N Melrose CT
Mequon, WI 53097-3834

Mailing address

9811 N Melrose CT
Mequon, WI 53097-3834
Phone (262) 242-6388

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
7738WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1750658563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 N MELROSE CT",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973834",
            "telephone_number": "262-242-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 N MELROSE CT",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973834",
            "telephone_number": "262-242-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYWICKE",
        "first_name": "JOHN",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "7738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.