Active NPI
Heather Cay Bolstad, PHARMD, RPH
- Pharmacist
- Mankato, MN
National Provider Identifier
1063774834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117014
- Practice address
- 1610 Monks Ave
Mankato, MN 56001-5173 - Phone
- (507) 625-1553
- NPI assigned
- Jun 7, 2012
- Last updated
- Jan 25, 2021
- Sex
- Female
- 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 | 117014 | MN | Primary |
Addresses
Primary practice location
1610 Monks Ave
Mankato, MN 56001-5173
Mailing address
209 5TH St SW
Elysian, MN 56028-9618
Phone (507) 327-9650
Other practice location 1
150 Western Ave NW
Faribault, MN 55021-4504
Phone (507) 332-0084
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117014 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611532800000",
"number": "1063774834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 5TH ST SW",
"city": "ELYSIAN",
"state": "MN",
"postal_code": "560289618",
"telephone_number": "507-327-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 MONKS AVE",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015173",
"telephone_number": "507-625-1553"
}
],
"practiceLocations": [
{
"address_1": "150 Western Ave NW",
"address_purpose": "LOCATION",
"city": "Faribault",
"state": "MN",
"postal_code": "550214504",
"country_code": "US",
"telephone_number": "507-332-0084",
"fax_number": "507-332-8572",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLSTAD",
"first_name": "HEATHER",
"middle_name": "CAY",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-07",
"last_updated": "2021-01-25",
"certification_date": "2021-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.