DR. JASON R GUNDRUM (NPI# 1285987628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285987628 |
| Entity Type | Individual |
| Full Name | DR. JASON R GUNDRUM |
| Credential | PHARMD. |
| Practice Address |
975 Port Washington Rd Grafton WI 53024-9201 |
| Practice Telephone | 2623291600 |
| Practice Fax Number | 2623291601 |
| Mailing Telephone | 2623291600 |
| Mailing Fax Number | 2623291601 |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 14219-40 | WI | Pharmacy Service Providers |
| Street Address |
975 PORT WASHINGTON RD |
| City | GRAFTON |
| State | WI |
| Zip Code | 53024-9201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292610 | Robert N. Fish | Anesthesiology | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2005-08-18 |
| 1700499845 | Melissa A Stock | Nurse Practitioner | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-08-28 |
| 1689292708 | Scott Thompson | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-07-07 |
| 1740807296 | Todd R Stanley | Registered Nurse | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-07-01 |
| 1639792666 | Emily Ann Feather | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-05-26 |
| 1073136180 | Jasleen Guru | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-05-22 |
| 1811517097 | William Knox | Occupational Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-04-17 |
| 1679192314 | Caitlin Marie Hill | Speech-Language Pathologist | 975 Port Washington Rd, Grafton, WI 53024-9204 | 2020-04-13 |
| 1447888789 | Beverly Altman | Massage Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-03-31 |
| 1013540566 | Matthew David Poli | Physician Assistant | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739135 | Kathy Anne Herzog | Counselor | 101 Falls Rd Suite 210, Grafton, WI 53024 | 2018-02-06 |
| 1992215867 | Caroline Marie Brandt | Nurse Practitioner | 975 Port Washington Rd Ste 310, Grafton, WI 53024 | 2017-10-05 |
| 1124569181 | Quirt Family Dentistry, Sc | Dentist | 1580 Port Washington Road, Grafton, WI 53024 | 2017-03-10 |
| 1639626260 | Jennifer Pogodzinski | Physical Therapist | 975 N. Port Washington Avenue, Grafton, WI 53024 | 2016-09-01 |
| 1750790119 | Amanda K Olejniczak | Dentist | 1505 Wisconsin Ave, Ste 130, Grafton, WI 53024 | 2014-08-10 |
| 1992053680 | Liliya Lakshtanov | Registered Nurse | 910 E. Paradise Dr., West Bend, WI 53024 | 2012-08-28 |
| 1467708446 | Trevor Holwell | Pharmacist | 1600 N Port Washington Rd, Grafton, WI 53024 | 2012-07-27 |
| 1770838120 | Brian A. Vetterkind | Physical Therapist | 2225 Wisconsin Ave Ste 100, Grafton, WI 53024 | 2012-07-20 |
| 1366774689 | Tracy Lynn Doro-krueger | Counselor | 1814 Arapaho Court, Grafton, WI 53024 | 2010-02-11 |
| 1659507754 | Karen Marie Geschke | Physical Therapist | 2020 Cheyenne Ct., Grafton, WI 53024 | 2009-06-03 |
| Find all providers in zip 53024 | ||||
| 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 |
|---|---|---|---|---|
| 1699329474 | Roger Dwayne Davidson IIi | Pharmacist | 12213 Avalon Dr, Grafton, OH 44044-9527 | 2019-07-30 |
| 1770965105 | Kevin Frank | Pharmacist | 2138 Delaware Ave Apt F, Grafton, WI 53024-9446 | 2015-06-22 |
| 1467708446 | Trevor Holwell | Pharmacist | 1600 N Port Washington Rd, Grafton, WI 53024 | 2012-07-27 |
| 1023304482 | Cathy Arndt | Pharmacist | 1250 N Port Washington Rd, Target T-1212, Grafton, WI 53024-9315 | 2011-06-23 |
| 1578861050 | Claire M Clasen | Pharmacist | 5500 George Washington Mem Hwy, Grafton, VA 23692-2764 | 2011-03-07 |
| 1770893455 | Krystal L Wheeler | Pharmacist | 544 Hill Ave, Grafton, ND 58237 | 2010-10-15 |
| 1932318136 | James Rystedt | Pharmacist | 440 Cherry St, Grafton, ND 58237-1737 | 2007-05-22 |
| 1083838007 | Jonathan Decker | Pharmacist | 6500 George Washington Mem Hwy, Grafton, VA 23692-2128 | 2007-04-12 |
| 1790887586 | Emily Devault | Pharmacist | 98 N Pike St, Grafton, WV 26354-1538 | 2006-09-02 |
| 1891395240 | Trent Wilson | Pharmacist | 1 Walmart Ln, Grafton, WV 26354-9537 | 2020-10-27 |
| Find all providers in GRAFTON | ||||
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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.