MR. MARK MENNICKE (NPI# 1538552401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538552401 |
| Entity Type | Individual |
| Full Name | MR. MARK MENNICKE |
| Credential | RPH |
| Practice Address |
3700 University Ave Madison WI 53705-2144 |
| Practice Telephone | 6082387109 |
| Practice Fax Number | 6082381089 |
| Mailing Telephone | 6082387109 |
| Mailing Fax Number | 6082381089 |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 9989-40 | WI | Pharmacy Service Providers |
| Street Address |
3700 UNIVERSITY AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53705-2144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609861434 | Ann Elizabeth Somers | Nurse Practitioner | 3700 University Ave, Madison, WI 53705-2144 | 2005-09-19 |
| 1477164515 | Kimberly James | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2020-08-12 |
| 1518319466 | Matt Holicek | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2016-07-04 |
| 1982038394 | Ryan James Anderson | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2013-08-21 |
| 1326489782 | Andrew S Kozicki | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2013-07-15 |
| 1912274291 | Nicole M Picotte | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2011-11-30 |
| 1043597321 | Justin Feldmeier | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2011-11-14 |
| 1053693184 | Matthew D Hustad | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2011-09-14 |
| 1013222520 | Salma M. Abdelaal | Pharmacist | 3700 University Ave, Madison, WI 53705-2144 | 2010-08-10 |
| 1295740199 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3700 University Ave, Madison, WI 53705-2144 | 2006-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629563986 | Magdalena Maria Siodlak | Pharmacist | 2500 Overlook Terrace (119), Madison, WI 53705 | 2018-06-28 |
| 1104343243 | Aisling Margaret Tallman | Physician Assistant | 725 University Row, Apt 124, Madison, WI 53705 | 2017-08-29 |
| 1346785938 | Rachel Maria Sanabria | Social Worker | 4513 Vernon Blvd Ste 100, Madison, WI 53705 | 2017-01-05 |
| 1124482856 | Samantha Jo Juve | Social Worker | 313 Price Pl Ste 212, Madison, WI 53705 | 2016-04-08 |
| 1912373002 | Brittany Dennis | Counselor | 5005 University Avenue, Suite 100, Madison, WI 53705 | 2015-08-12 |
| 1225456981 | John Martin Floberg | Radiology | 2140, Med 4 Mailbox, Hslc, 750 Highland Ave., Madison, WI 53705 | 2014-03-31 |
| 1457693319 | Matthew Ryan May-curry | Psychiatry & Neurology | 2500 Overlook Ter # 116a, Madison, WI 53705 | 2013-03-19 |
| 1396083168 | Madison Psychiatric & Psychological Services | Psychiatry & Neurology | 702 N. Blackhawk Ave, #100, Madison, WI 53705 | 2013-01-29 |
| 1174872808 | Natasha Bulat | Massage Therapist | 5317 Old Middleton Rd, Room #102, 'hot Stone Therapy & Massage', Madison, WI 53705 | 2012-09-10 |
| 1033401609 | Ann B Braus | Family Medicine | 6209 Mineral Point Rd, Madison, WI 53705 | 2011-05-13 |
| Find all providers in zip 53705 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840956 | Candi Ashton | Pharmacist | 6011 N Rector Rd, Madison, IN 47250-7624 | 2020-11-01 |
| 1154931038 | Alyson Giragosian | Pharmacist | 4818 Kingsford Way, Madison, WI 53704-6498 | 2020-08-05 |
| 1801415641 | Genesee Fernandez | Pharmacist | 170 Sagebrook Dr, Madison, AL 35757-7684 | 2020-04-12 |
| 1417583568 | Kimberly Maerz | Pharmacist | 6701 Mineral Point Rd, Madison, WI 53705-4241 | 2020-03-20 |
| 1942845896 | Nikita Jain | Pharmacist | 857 Durham Rd, Madison, CT 06443-1827 | 2019-11-14 |
| 1437704939 | Morgan A Wynes | Pharmacist | 600 Highland Ave # F6160, Madison, WI 53792-0001 | 2019-08-02 |
| 1467005322 | Elisa Rowland | Pharmacist | 12070 County Line Rd Ste C, Madison, AL 35756-2000 | 2019-07-19 |
| 1669034849 | Jessica Chmielinski | Pharmacist | 2500 Overlook Ter Dept 119, Madison, WI 53705-2254 | 2019-07-08 |
| 1265903702 | Steven Michael Dixon | Pharmacist | 41 Chestnut Hill Rd, Madison, CT 06443-1816 | 2018-12-10 |
| 1609358050 | Fallon Callahan | Pharmacist | 136 Samson Rock Drive, Madison, CT 06413 | 2018-09-02 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.