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Deactivated NPI 1396914529 Deactivated / Inactive NPI Male Practitioner

Jerome Anton Wallenfang , RPH

Pharmacist • Appleton, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jerome Wallenfang has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 21, 2008
NPI Deactivation Date July 21, 2022
Total Practice Duration ~14 Years of Practice (2008 – 2022)

Professional Overview & Biography Verified Profile Summary

Jerome Wallenfang, RPH was a registered Pharmacist practicing in Appleton, WI. Throughout an active medical career spanning 14 years, Jerome Wallenfang provided care at the practice location at N276 GILLAN CT until profile deactivation on 2022-07-21.

Practice Location & Contact Primary Location

Practice Address

N276 Gillan Ct

Appleton, WI 549155502

Telephone 9207886901

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Appleton, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
134 Specialists

Practicing in Appleton, WI (5503 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License WI 8748

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 21, 2022

Record deactivated on July 21, 2022

NPI Profile Active February 21, 2008

NPI status registered as active in NPPES database

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Updated Practice Location February 21, 2008

Registered at N276 GILLAN CT, APPLETON, WI 549155502 (Tel: 9207886901)

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Updated Business Mailing Address February 21, 2008

Registered at N276 GILLAN CT, APPLETON, WI 549155502 (Tel: 9207886901)

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Provider Name / Credentials Updated February 21, 2008

Recorded as JEROME WALLENFANG, R.PH.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2008

Pharmacist (License #8748 in WI)

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Initial NPI Registration & Enumeration February 21, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396914529
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2008
Last Update: February 21, 2008
Deactivation Date: July 21, 2022

Mailing Address

N276 Gillan Ct

Appleton, WI 549155502

Phone: 9207886901

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.