Active NPI
Jeffrey Richard Otto, RPH
- Pharmacist
- Menomonee Falls, WI
National Provider Identifier
1982991527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12967-040
- Practice address
- N95W17707 Shady LN
Menomonee Falls, WI 53051-8012 - Phone
- (262) 415-0005
- Fax
- (262) 415-0005
- NPI assigned
- Jul 4, 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 | 12967-040 | WI | Primary |
Addresses
Primary practice location
N95W17707 Shady LN
Menomonee Falls, WI 53051-8012
Mailing address
N95W17707 Shady LN
Menomonee Falls, WI 53051-8012
Phone (262) 415-0005
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 |
|---|---|---|---|
| 12967-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309737600000",
"number": "1982991527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N95W17707 SHADY LN",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530518012",
"telephone_number": "262-415-0005",
"fax_number": "262-415-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N95W17707 SHADY LN",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530518012",
"telephone_number": "262-415-0005",
"fax_number": "262-415-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "JEFFREY",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-04",
"last_updated": "2011-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12967-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.