Individual provider Active NPI

Kristina Marie Bennwitz, PHARMD

  • Pharmacist
  • Madison, WI
National Provider Identifier
1760891378
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1756340 Issued in WI
Practice address
4122 E Towne Blvd
Madison, WI 53704-3732
Phone
(608) 242-6862
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1756340 WI Primary

Addresses

Primary practice location

4122 E Towne Blvd
Madison, WI 53704-3732

Mailing address

4122 E Towne Blvd
Madison, WI 53704-3732
Phone (608) 242-6862

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
1756340WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1760891378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 E TOWNE BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043732",
            "telephone_number": "608-242-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 E TOWNE BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043732",
            "telephone_number": "608-242-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNWITZ",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "1756340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.