NPIMap

Individual provider Active NPI

Scott Michael Farrell, DPHARM

  • Pharmacist
  • Beaver Dam, WI
National Provider Identifier
1831474030
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14293-040 Issued in WI
Practice address
607 Park Ave
Beaver Dam, WI 53916-2201
Phone
(920) 356-0148
Fax
(920) 356-0401
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14293-040 WI Primary

Addresses

Primary practice location

607 Park Ave
Beaver Dam, WI 53916-2201

Mailing address

607 Park Ave
Beaver Dam, WI 53916-2201
Phone (920) 356-0148

Other names 1

  • Scotty M Farrell Other name

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

LicenseStateTypeSpecialty
14293-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Mar 20, 2022 Accepting new patients

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1831474030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PARK AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162201",
            "telephone_number": "920-356-0148",
            "fax_number": "920-346-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 PARK AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162201",
            "telephone_number": "920-356-0148",
            "fax_number": "920-356-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "credential": "DPHARM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "14293-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SCOTTY",
            "last_name": "FARRELL",
            "middle_name": "M",
            "credential": "DPHARM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.