Active NPI
Brian Schultz
- Pharmacist
- Wautoma, WI
National Provider Identifier
1780954289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10723-40
- Practice address
- N2934 Hwy 22 N
Wautoma, WI 54982 - Phone
- (920) 787-5757
- Fax
- (920) 787-5382
- NPI assigned
- Dec 31, 2011
- Last updated
- Oct 14, 2014
- Sex
- Male
- 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 | 10723-40 | WI | Primary |
Addresses
Primary practice location
N2934 Hwy 22 N
Wautoma, WI 54982
Mailing address
250 Century Dr
Wautoma, WI 54982-7710
Phone (706) 669-8251
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10723-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413244800000",
"number": "1780954289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 CENTURY DR",
"city": "WAUTOMA",
"state": "WI",
"postal_code": "549827710",
"telephone_number": "706-669-8251",
"fax_number": "920-787-5382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N2934 HWY 22 N",
"city": "WAUTOMA",
"state": "WI",
"postal_code": "54982",
"telephone_number": "920-787-5757",
"fax_number": "920-787-5382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-31",
"last_updated": "2014-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "10723-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wautoma, WI
- Larry Dale Rowland, DDS
- Jill Salettel, DENTAL HYGIENIST
- Anna J Schaffer, DDS
- Lori Ann Schnese, RPH
- Amy Schoenoff, APNP
- Megan Schwobe, APSW
- Susan Shemanski, CADC III
- Shopko Stores Operating Co LLC (Shopko Optical)
- Shopko Stores Operating Co LLC (Shopko Pharmacy 617)
- Shopko Stores Operating Co., LLC (Shopko Pharmacy 2214)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.