Individual provider Active NPI

Charlene Wiegand

  • Pharmacist
  • Wauwatosa, WI
National Provider Identifier
1942834593
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18511-40 Issued in WI
Practice address
2275 N Mayfair Rd
Wauwatosa, WI 53226-2207
Phone
(414) 774-4821
NPI assigned
Feb 22, 2020
Last updated
Feb 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18511-40 WI Primary

Addresses

Primary practice location

2275 N Mayfair Rd
Wauwatosa, WI 53226-2207

Mailing address

2275 N Mayfair Rd
Wauwatosa, WI 53226-2207
Phone (414) 774-4821

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

LicenseStateTypeSpecialty
18511-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1582329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1942834593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262207",
            "telephone_number": "414-774-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262207",
            "telephone_number": "414-774-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-22",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "18511-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.