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Dr. Ethan Nathaniel Mcfaddin , PharmD

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist β€’ Kenosha, WI

Active NPI 1386274413 Individual Practitioner Male Practitioner
Practice location in NPPES

10400 75th St
Kenosha, WI 531427884

Call 2629487040 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

10400 75th St

Kenosha, WI 531427884

Telephone 2629487040
Organization at the Same NPPES Address or Phone
Mea-Aea Kenosha Sc Facility NPI 1477546737

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Compared with the same specialty in Kenosha and Wisconsin

7 active clinicians are listed under Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist with a practice address in Kenosha, WI (253 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-09-14
Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Primary Specialty

NUCC Taxonomy Code: 1835P0018X

License # reported to NPPES WI 20196-40

Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

40 listed
Dr. John Agaiby , MD

Family Medicine

NPI 1235147877

Doctor of Medicine (M.D.)

Nancy Aiello , NP

Nurse Practitioner

NPI 1821427568

Nurse Practitioner

Nicholas Alessi , NP

Nurse Practitioner

NPI 1427714773

Nurse Practitioner

Dr. Mary Ames , MD

Obstetrics & Gynecology - Maternal & Fetal Medicine

NPI 1215989751

Doctor of Medicine (M.D.)

Dr. Alby Antoo , MD

Family Medicine

NPI 1407864093

Doctor of Medicine (M.D.)

NPI 1760422240

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2026

Pharmacist (license number reported to NPPES: WI 20196-40)

βœ…
NPI Profile Active January 16, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 16, 2020

Registered at 10400 75TH ST, KENOSHA, WI 531427884 (Tel: 2629487040)

πŸ“
Business Mailing Address (Initial Record) January 16, 2020

Registered at 10400 75TH ST, KENOSHA, WI 531427884 (Tel: 2629487040)

πŸ‘€
Provider Name / Credentials (Initial Record) January 16, 2020

Recorded as ETHAN MCFADDIN, PHARMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2020

Pharmacist (license number reported to NPPES: WI 20196-40)

🟒
Initial NPI Registration & Enumeration January 16, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1386274413
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2020
Last Update: September 14, 2026
Sole Proprietor: No

Mailing Address

10400 75th St

Kenosha, WI 531427884

Phone: 2629487040

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.