Gary A Donaldson, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

12092040 Issued in WI

Practice address

15481 Commercial Rd
Lakewood, WI 54138-9677

Phone

(715) 276-3646

Fax

(715) 276-9568

NPI assigned

Dec 13, 2007

Last updated

Dec 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicolet Pharmacy Inc

  dba Nicolet Pharmacy

  • Community/Retail Pharmacy
  • Lakewood, WI
  • NPI 1851321566
  Authorized official Same address or phone
• Nicolet Pharmacy, Inc.

  dba Nicolet Pharmacy Inc-340B Pharmacy

  • Community/Retail Pharmacy
  • Lakewood, WI
  • NPI 1114290707
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1841473717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15481 COMMERCIAL RD",
            "city": "LAKEWOOD",
            "state": "WI",
            "postal_code": "541389677",
            "telephone_number": "715-276-3646",
            "fax_number": "715-276-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15481 COMMERCIAL RD",
            "city": "LAKEWOOD",
            "state": "WI",
            "postal_code": "541389677",
            "telephone_number": "715-276-3646",
            "fax_number": "715-276-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "GARY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12092040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Boney, APNP
• Peggy S Christianson, APRN
• Janet M Dailey, FNP
• Melissa Day, APSW
• Muhammad Saadah Diab, DMD
• Blake J Edinger, D.D.S.
• Rene A Farah, R.D.H.
• Christi Fowler, MS, NCC, LPC
• Leslee A Granke, APNP
• Ashlei Elaine Guarisco, R.D.H.

• Pharmacist in Lakewood, WI
• Providers in Lakewood, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.