Active NPI
Kevin Glenn Wurtz, PHARMACIST
- Pharmacist
- Elk Point, SD
National Provider Identifier
1801159397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3912
- Practice address
- 107 E Main
Elk Point, SD 57025-0489 - Phone
- (605) 356-3336
- NPI assigned
- Jun 19, 2012
- 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 | 3912 | SD | Primary |
Addresses
Primary practice location
107 E Main
Elk Point, SD 57025-0489
Mailing address
PO Box 489
Elk Point, SD 57025-0489
Phone (605) 356-3336
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 |
|---|---|---|---|
| 3912 | SD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health Network | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Onawa, IA
- NPI 1336982677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340928000000",
"number": "1801159397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 489",
"city": "ELK POINT",
"state": "SD",
"postal_code": "570250489",
"telephone_number": "605-356-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E MAIN",
"city": "ELK POINT",
"state": "SD",
"postal_code": "570250489",
"telephone_number": "605-356-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WURTZ",
"first_name": "KEVIN",
"middle_name": "GLENN",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-19",
"last_updated": "2012-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "3912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Point, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.