Individual provider Active NPI

Kevin M Hoey, R.PH.

  • Pharmacist
  • Cottage Grove, WI
National Provider Identifier
1770760811
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11164-040 Issued in WI
Practice address
431 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone
(608) 839-3784
Fax
(608) 839-3786
NPI assigned
Jan 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11164-040 WI Primary

Addresses

Primary practice location

431 W Cottage Grove Rd
Cottage Grove, WI 53527-9385

Mailing address

431 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone (608) 839-3784

Other identifiers 1

IdentifierTypeStateIssuer
11164-040OtherWIWI RPH LICENSE

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

LicenseStateTypeSpecialty
11164-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
SKJ Inc. Current Accepting new patients
SKJ Inc Current Accepting new patients

Locations

431 W Cottage Grove Rd
Cottage Grove, WI 53527
Phone (608) 839-3784

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": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1770760811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279385",
            "telephone_number": "608-839-3784",
            "fax_number": "608-839-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279385",
            "telephone_number": "608-839-3784",
            "fax_number": "608-839-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOEY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "11164-040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI RPH LICENSE",
            "identifier": "11164-040",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.