Active NPI
Jesse Allan Skogstad I, PHARMD
- Pharmacist
- International Falls, MN
National Provider Identifier
1043982796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 125370
- Practice address
- 314 3Rd St
International Falls, MN 56649-2309 - Phone
- (218) 283-3061
- NPI assigned
- Oct 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 125370 | MN | Primary |
Addresses
Primary practice location
314 3Rd St
International Falls, MN 56649-2309
Mailing address
4389 Town Road 403 S
International Falls, MN 56649-9125
Phone (218) 290-5627
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
| License | State | Type | Specialty |
|---|---|---|---|
| 125370 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1043982796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4389 TOWN ROAD 403 S",
"city": "INTERNATIONAL FALLS",
"state": "MN",
"postal_code": "566499125",
"telephone_number": "218-290-5627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 3RD ST",
"city": "INTERNATIONAL FALLS",
"state": "MN",
"postal_code": "566492309",
"telephone_number": "218-283-3061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOGSTAD",
"first_name": "JESSE",
"middle_name": "ALLAN",
"name_suffix": "I",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "125370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in International Falls, MN
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Amy Schaffer, MA, LPP, LPC
- Shailynn Nicole Shipley, APRN, CNP
- Roxanne Tillie Skogstad-Ditsch, M.ED., N.A.D.-III, L
- Jenny Skoog, PTA
- Tim Allen Smith, M.D.
- Nicholas Lee Starr, PSYD
- Anthony Christian Stone
- Doreen Evonne Swendsen, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.