Active NPI
Katarzyna Anna Fortuna-Garcia, PHARMD
- Pharmacist
- Kenosha, WI
National Provider Identifier
1891329389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19166-40
- Practice address
- 3805 80TH St
Kenosha, WI 53142-4951 - Phone
- (262) 694-0750
- NPI assigned
- Feb 24, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19166-40 | WI | Primary |
| Pharmacist | 183500000X | 051.301236 | IL |
Addresses
Primary practice location
3805 80TH St
Kenosha, WI 53142-4951
Mailing address
3805 80TH St
Kenosha, WI 53142-4951
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 |
|---|---|---|---|
| 051.301236 | IL | MD | Pharmacist |
| 19166-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3805 80th St
Kenosha, WI 53142
Phone (262) 694-0750
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": "1582502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1891329389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3805 80TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531424951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805 80TH ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531424951",
"telephone_number": "262-694-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNA-GARCIA",
"first_name": "KATARZYNA",
"middle_name": "ANNA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-24",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19166-40",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.301236",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.