Collin Ryan Davis, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

126637 Issued in MN

Practice address

1215 E Superior St
Duluth, MN 55802-2218

Phone

(218) 724-3735

NPI assigned

Aug 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grand St Paul CVS LLC

  • Pharmacy
  • Plymouth, MN
  • NPI 1437620903
  NPD (past)
• Grand St Paul CVS LLC

  • Pharmacy
  • Duluth, MN
  • NPI 1952715096
  NPD (past)

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1023841707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 GRAND AVE # A",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072850",
            "telephone_number": "402-310-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022218",
            "telephone_number": "218-724-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COLLIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "126637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Thomas Davies, MD
• Andrew Davis, M.D.
• Anne Davis, RDH, DT
• Brad Jacob Davis
• Brian Roy Davis
• Emily K Davis, APRN,CNM
• J. Joseph Davis
• Jefferson John Davis, DO
• Julianne Marie Davis, PSYD
• Leah A Davis, APRN, CRNA

• Pharmacist in Duluth, MN
• Providers in Duluth, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.