Active NPI
Andrew D Wheaton, PHARMD
- Pharmacist
- Menasha, WI
National Provider Identifier
1811255722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14490-040
- Practice address
- 1029 Tana LN
Menasha, WI 54952-2960 - Phone
- (920) 882-9241
- NPI assigned
- Apr 27, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 14490-040 | WI | Primary |
Addresses
Primary practice location
1029 Tana LN
Menasha, WI 54952-2960
Mailing address
1029 Tana LN
Menasha, WI 54952-2960
Phone (920) 882-9241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14490-040 | Other | WI | STATE 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14490-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335484800000",
"number": "1811255722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1029 TANA LN",
"city": "MENASHA",
"state": "WI",
"postal_code": "549522960",
"telephone_number": "920-882-9241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 TANA LN",
"city": "MENASHA",
"state": "WI",
"postal_code": "549522960",
"telephone_number": "920-882-9241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEATON",
"first_name": "ANDREW",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-27",
"last_updated": "2012-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14490-040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "14490-040",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.