Kellen Dorff, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

1907340 Issued in WI

Practice address

400 S Townline Rd
Wautoma, WI 54982-6922

Phone

(920) 647-8984

Fax

(920) 647-8991

NPI assigned

Feb 20, 2020

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

Doctor of Pharmacy

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Columbus, WI
  • NPI 1689756157
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1902439748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE RD",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826922",
            "telephone_number": "920-647-8984",
            "fax_number": "920-647-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE RD",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826922",
            "telephone_number": "920-647-8984",
            "fax_number": "920-647-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFF",
        "first_name": "KELLEN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "1907340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David N Crowther, MD
• Jennifer Dolores Culver, PHD
• Nathan L Daily, DDS
• Randi Davis, LPCIT
• Jordan Dietrich, DDS
• Katrina L Dorow Stevens, MA
• Paige Dorsey, APNP
• Veronica Eckstein, CSAC
• Lori Dale Erdman
• Kimberly Fairchild, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.