Individual provider Active NPI

Avni A Novotny, PHARMD

  • Pharmacist
  • Saint Paul, MN
National Provider Identifier
1003154998
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
119474 Issued in MN
Practice address
2199 Highway 36 E
Saint Paul, MN 55109-2215
Phone
(651) 779-6341
Fax
(651) 234-4734
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119474 MN Primary

Addresses

Primary practice location

2199 Highway 36 E
Saint Paul, MN 55109-2215

Mailing address

2199 Highway 36 E
Saint Paul, MN 55109-2215
Phone (651) 779-6341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
119474MNMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1003154998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2199 HIGHWAY 36 E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551092215",
            "telephone_number": "651-779-6341",
            "fax_number": "651-234-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2199 HIGHWAY 36 E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551092215",
            "telephone_number": "651-779-6341",
            "fax_number": "651-234-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "AVNI",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.