Active NPI
Tiffany Palm, PHARM.D.
- Pharmacist
- Jefferson, WI
National Provider Identifier
1841693751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17753-40
- Practice address
- 132 S Main St
Jefferson, WI 53549-1632 - Phone
- (920) 674-5733
- NPI assigned
- Oct 6, 2014
- Sex
- Female
- 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 | 17753-40 | WI | Primary |
Addresses
Primary practice location
132 S Main St
Jefferson, WI 53549-1632
Mailing address
132 S Main St
PO Box 116
Jefferson, WI 53549-1632
Phone (920) 674-5733
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 |
|---|---|---|---|
| 17753-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mueller Drugs, Inc. | Pharmacist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1841693751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 S MAIN ST",
"address_2": "PO BOX 116",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491632",
"telephone_number": "920-674-5733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 S MAIN ST",
"city": "JEFFERSON",
"state": "WI",
"postal_code": "535491632",
"telephone_number": "920-674-5733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALM",
"first_name": "TIFFANY",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-06",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "17753-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.