Individual provider Active NPI

Rebecca J Laing, PHARMD

  • Community/Retail Pharmacy
  • Eagan, MN
National Provider Identifier
1023606472
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
116039 Issued in MN
Practice address
4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Phone
(651) 688-7041
NPI assigned
Dec 31, 2020
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 116039 MN Primary

Addresses

Primary practice location

4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235

Mailing address

4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Phone (651) 688-7041

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
116039MNMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1023606472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 JOHNNY CAKE RIDGE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222235",
            "telephone_number": "651-688-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 JOHNNY CAKE RIDGE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222235",
            "telephone_number": "651-688-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAING",
        "first_name": "REBECCA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "116039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.