DR. KEVIN DALE MATHIS (NPI# 1891079695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891079695 |
| Entity Type | Individual |
| Full Name | DR. KEVIN DALE MATHIS |
| Credential | PHARMD |
| Practice Address |
109 N Marquette Rd Prairie Du Chien WI 53821-1512 |
| Practice Telephone | 6083260581 |
| Practice Fax Number | 6083260586 |
| Mailing Telephone | 6083260581 |
| Mailing Fax Number | 6083260586 |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 14346 | WI | Pharmacy Service Providers |
| Street Address |
109 N MARQUETTE RD |
| City | PRAIRIE DU CHIEN |
| State | WI |
| Zip Code | 53821-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083796429 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2006-10-19 |
| 1497389720 | Jared L Szabo | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2020-02-25 |
| 1114325206 | Susan Renee Diamond | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2014-12-05 |
| 1760899892 | Kelsey M Huber | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2014-07-21 |
| 1124395124 | Michael D Bouzek | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2011-11-19 |
| 1710260583 | Matthew Calvin Hill | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2011-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821539107 | Morgan Jewell Faulkner | Occupational Therapist | 700 S. Fremont St., Prairie Du Chien, WI 53821 | 2017-03-20 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1952551525 | Stacy L. Blackburn | Family Medicine | 800 Blackhawk Avenue, Prairie Du Chien, WI 53821 | 2008-09-19 |
| 1124276985 | Lori Knapp Crawford, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 South Beaumont Rd, Prairie Du Chien, WI 53821 | 2008-09-05 |
| 1386774834 | Jan R Kieser | Dentist | 7265 Beaumont Rd, Prairie Du Chien, WI 53821 | 2007-03-06 |
| 1437239209 | Bruce Lee Pomerening | Dentist | 109 South Beaumont Rd, Prairie Du Chien, WI 53821 | 2006-10-16 |
| 1386738078 | Edwin Herbert Neumann | Optometrist | 38020 Hwy 18, Prairie Du Chien, WI 53821 | 2006-10-03 |
| 1063515179 | Dental Associates of Prairie Du Chien PC | Dentist | 820 S Marquette Rd, Prairie Du Chien, WI 53821 | 2006-09-06 |
| 1811947492 | Mayo Clinic Health System - Franciscan Medical Center, Inc. | Durable Medical Equipment & Medical Supplies | 800 East Blackhawk Avenue, Prairie Du Chien, WI 53821 | 2006-05-12 |
| 1497759070 | Sara J Rybarczyk | Internal Medicine | 610 East Taylor St, Prairie Du Chien, WI 53821 | 2005-06-10 |
| Find all providers in zip 53821 | ||||
| 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 |
|---|---|---|---|---|
| 1730788837 | Anne Marie Fassbinder | Pharmacist | 38020 Us Highway 18, Prairie Du Chien, WI 53821-8206 | 2020-10-20 |
| 1265030902 | Jeffrey Mcdonald | Pharmacist | 38020 Us Highway 18, Prairie Du Chien, WI 53821-8206 | 2020-10-14 |
| 1841809316 | Kelsey Ann Hamann | Pharmacist | 610 E Taylor St, Prairie Du Chien, WI 53821-2109 | 2020-07-30 |
| 1649895897 | Erin M Greenya | Pharmacist | 101 S Marquette Rd, Prairie Du Chien, WI 53821-1639 | 2020-06-13 |
| 1497389720 | Jared L Szabo | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2020-02-25 |
| 1235590076 | Danette Gibbs | Pharmacist | 101 S Marquette Rd, Prairie Du Chien, WI 53821-1639 | 2016-03-07 |
| 1114325206 | Susan Renee Diamond | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2014-12-05 |
| 1760899892 | Kelsey M Huber | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2014-07-21 |
| 1124395124 | Michael D Bouzek | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2011-11-19 |
| 1710260583 | Matthew Calvin Hill | Pharmacist | 109 N Marquette Rd, Prairie Du Chien, WI 53821-1512 | 2011-09-27 |
| Find all providers in PRAIRIE DU CHIEN | ||||
| City | PRAIRIE DU CHIEN |
| Zip Code | 53821 |
Please comment or provide details below to improve the information on DR. KEVIN DALE MATHIS.
| 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.