Active NPI
Cheryl Ann Mertens, BSPHARM
- Pharmacist
- Luck, WI
National Provider Identifier
1902129828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11179
- Practice address
- 132 S Main St
Luck, WI 54853 - Phone
- (715) 472-2122
- Fax
- (715) 472-4423
- NPI assigned
- Mar 5, 2010
- Last updated
- Nov 18, 2013
- 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 | 11179 | WI | Primary |
| Pharmacist | 183500000X | 114480 | MN |
Addresses
Primary practice location
132 S Main St
Luck, WI 54853
Mailing address
PO Box 1
New Richmond, WI 54017-0001
Phone (715) 246-8667
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
| License | State | Type | Specialty |
|---|---|---|---|
| 114480 | MN | MD | Pharmacist |
| 11179 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luck Pharmacy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1902129828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540170001",
"telephone_number": "715-246-8667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 S MAIN ST",
"city": "LUCK",
"state": "WI",
"postal_code": "54853",
"telephone_number": "715-472-2122",
"fax_number": "715-472-4423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERTENS",
"first_name": "CHERYL",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "BSPHARM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-05",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11179",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "114480",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Luck, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.