Active NPI
Kevin J Plzak, RPH
- Pharmacist
- Oshkosh, WI
National Provider Identifier
1962779140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10892-40
- Practice address
- 1900 S Koeller St
Oshkosh, WI 54902-6153 - Phone
- (920) 233-4287
- NPI assigned
- Nov 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 10892-40 | WI | Primary |
Addresses
Primary practice location
1900 S Koeller St
Oshkosh, WI 54902-6153
Mailing address
1130 E Nawada St
Appleton, WI 54911-5271
Phone (920) 268-8903
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10892-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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.
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- Pharmacy
- Appleton, WI
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1962779140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 E NAWADA ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549115271",
"telephone_number": "920-268-8903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 S KOELLER ST",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549026153",
"telephone_number": "920-233-4287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLZAK",
"first_name": "KEVIN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "10892-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.