Individual provider Active NPI

Ryan D Lundell, R.PH.

  • Pharmacotherapy Pharmacist
  • St. Cloud, MN
National Provider Identifier
1043223779
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
116665-5 Issued in MN
Practice address
St. Cloud Veterans Affairs Medical Center
4801 8TH Street North
St. Cloud, MN 56303-2099
Phone
(320) 255-6465
Fax
(320) 255-6360
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 116665-5 MN
Pharmacist 183500000X 4721 ND
Pharmacotherapy Pharmacist 1835P1200X 116665-5 MN Primary

Addresses

Primary practice location

St. Cloud Veterans Affairs Medical Center
4801 8TH Street North
St. Cloud, MN 56303-2099

Mailing address

1 Michaels Court
Sartell, MN 56377-2012

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4721NDMDPharmacist
116665-5MNMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1043223779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MICHAELS COURT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. CLOUD VETERANS AFFAIRS MEDICAL CENTER",
            "address_2": "4801 8TH STREET NORTH",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "563032099",
            "telephone_number": "320-255-6465",
            "fax_number": "320-255-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "RYAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116665-5",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "4721",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "116665-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.