Active NPI
Mary Jo Houston, RPH
- Pharmacist
- Oconomowoc, WI
National Provider Identifier
1760099618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11573
- Practice address
- 1021 Summit Ave
Oconomowoc, WI 53066-4499 - Phone
- (262) 567-9173
- NPI assigned
- Sep 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 11573 | WI | Primary |
Addresses
Primary practice location
1021 Summit Ave
Oconomowoc, WI 53066-4499
Mailing address
710 Majestic View LN
Oconomowoc, WI 53066-6508
Phone (262) 308-5498
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11573 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1021 Summit Ave
Oconomowoc, WI 53066
Phone (262) 567-9173
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1760099618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 MAJESTIC VIEW LN",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530666508",
"telephone_number": "262-308-5498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 SUMMIT AVE",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664499",
"telephone_number": "262-567-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "MARY",
"middle_name": "JO",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-24",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
- Raina L Hollenbaugh, M.D.
- Charles Todd Holsen, DDS
- Homes for Independent Living of Wisconsin LLC (Homes For Independent Living HIL)
- Mary E Horner, NP
- Kayla Housh-Kornowski, LPC
- Howard V. Elconin, M.D., S.C.
- Brooke Huckabay, LPC
- Emily Nicole Huenink, PT, DPT
- Jack W Hutter, DPM
- Internal Medicine Clinic SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.