Active NPI
William James Wall Jr.
- Pharmacist
- Reedsburg, WI
National Provider Identifier
1952063760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21157-40
- Practice address
- 150 Viking Dr
Reedsburg, WI 53959-1435 - Phone
- (608) 524-6868
- NPI assigned
- Oct 8, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 21157-40 | WI | Primary |
Addresses
Primary practice location
150 Viking Dr
Reedsburg, WI 53959-1435
Mailing address
1820 Huntington Park Dr Apt 1112
Reedsburg, WI 53959-1467
Phone (757) 968-2731
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 |
|---|---|---|---|
| 21157-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633651200000",
"number": "1952063760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 HUNTINGTON PARK DR APT 1112",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591467",
"telephone_number": "757-968-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 VIKING DR",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591435",
"telephone_number": "608-524-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "WILLIAM",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-08",
"last_updated": "2021-10-08",
"certification_date": "2021-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "21157-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reedsburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.