MR. GARY J KORTHALS (NPI# 1316276660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316276660 |
| Entity Type | Individual |
| Full Name | MR. GARY J KORTHALS |
| Credential | RPH |
| Practice Address |
201 S. Water St Sparta WI 54656 |
| Practice Telephone | 6082692949 |
| Practice Fax Number | 6082693330 |
| Mailing Telephone | 6082692949 |
| Mailing Fax Number | 6082693330 |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2017-04-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 10424-40 | WI | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 10424 | WI | Pharmacy Service Providers |
| Street Address |
201 S. WATER ST |
| City | SPARTA |
| State | WI |
| Zip Code | 54656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929279 | Jennifer Johnson | Physical Therapy Assistant | 14345 County Hwy B, Sparta, WI 54656 | 2016-09-01 |
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1801223003 | Emily M Nolte | Counselor | 112 S Court St. Room 3000, Sparta, WI 54656 | 2013-10-02 |
| 1518254945 | Therapeutic Home Services | Point of Service | 9484 Festival Avenue, Sparta, WI 54656 | 2011-07-06 |
| 1639488273 | Rebecca Ann Frey | Reflexologist | 5680 Canary Ave, Sparta, WI 54656 | 2010-09-30 |
| 1689847329 | Donald N. La Force | Hearing Instrument Specialist | 117 West Oak St, Sparta, WI 54656 | 2008-04-02 |
| 1164400503 | Alice M Bachop | Nurse Practitioner | 310 West Main Street, Sparta, WI 54656 | 2006-01-05 |
| 1578540894 | Marc D Tumerman | Family Medicine | 310 West Main St, Sparta, WI 54656 | 2005-12-28 |
| 1003398488 | Ariel Dawn Ferdock | Pharmacist | 310 W Main St, Sparta, WI 54656 | 2018-09-03 |
| 1972001881 | Carmen Alyssa Adams | Physician Assistant | 1111 W Wisconsin St, Sparta, WI 54656 | 2018-01-25 |
| Find all providers in zip 54656 | ||||
| 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 |
|---|---|---|---|---|
| 1629533823 | James Clinton Barlow | Pharmacist | 2560 Sullivan Knowles Rd, Sparta, TN 38583-4765 | 2019-02-01 |
| 1942798210 | Oscar Dale Sims | Pharmacist | 202 Sam Walton Drive, Sparta, TN 38583 | 2018-04-23 |
| 1609318559 | April Lawson | Pharmacist | 5289 Hwy 15 South, Sparta, GA 31087 | 2016-11-09 |
| 1154619898 | Abbie Howell | Pharmacist | 460 West Bockman Way, Sparta, TN 38583 | 2011-07-15 |
| 1659673317 | Nicoletta Z Donati | Pharmacist | 55 Waters Edge, Sparta, NJ 07871-3850 | 2010-11-30 |
| 1982859534 | Jeffrey P Brown | Pharmacist | 419 Highland Meadows Dr, Sparta, WI 54656-1555 | 2008-11-24 |
| 1164556759 | Leslie Ann Reagan | Pharmacist | 207 West Town Plaza, Sparta, TN 38583 | 2007-03-15 |
| 1699801225 | John Allen Vanpopering | Pharmacist | 11 E Division St, Sparta, MI 49345-1325 | 2007-02-26 |
| 1881761021 | Robert Maurice Halverson Jr. | Pharmacist | 1123 Sherri Dr, Sparta, WI 54656-2084 | 2006-11-30 |
| 1821107616 | Elsa Iglesias | Pharmacist | 1 Theatre Ctr, Sparta, NJ 07871-2405 | 2006-08-29 |
| Find all providers in SPARTA | ||||
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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.