Individual provider Active NPI

Anthony Daniel Peterangelo, R.PH.

  • Pharmacist
  • MC Farland, WI
National Provider Identifier
1982646048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13910-040 Issued in WI
Practice address
4880 Larson Beach Rd
MC Farland, WI 53558-8724
Phone
(608) 838-7455
Fax
(608) 838-8329
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13910-040 WI Primary

Addresses

Primary practice location

4880 Larson Beach Rd
MC Farland, WI 53558-8724

Mailing address

721 N Star Dr
Madison, WI 53718-3075

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

LicenseStateTypeSpecialty
13910-040WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982646048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N STAR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 LARSON BEACH RD",
            "city": "MC FARLAND",
            "state": "WI",
            "postal_code": "535588724",
            "telephone_number": "608-838-7455",
            "fax_number": "608-838-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERANGELO",
        "first_name": "ANTHONY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13910-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Farland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.