Individual provider Active NPI

Jan M Monley, PHARM. D.

  • Pharmacist
  • Deer River, MN
National Provider Identifier
1093922684
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
115402 Issued in MN
Practice address
1002 Comstock Dr
Deer River, MN 56636-9700
Phone
(218) 246-3071
Fax
(218) 246-1924
NPI assigned
May 16, 2007
Last updated
Feb 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 115402 MN Primary

Addresses

Primary practice location

1002 Comstock Dr
Deer River, MN 56636-9700

Mailing address

34905 Christmas LN
Grand Rapids, MN 55744-5383
Phone (218) 326-5062

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
115402MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1093922684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34905 CHRISTMAS LN",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557445383",
            "telephone_number": "218-326-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 COMSTOCK DR",
            "city": "DEER RIVER",
            "state": "MN",
            "postal_code": "566369700",
            "telephone_number": "218-246-3071",
            "fax_number": "218-246-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONLEY",
        "first_name": "JAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "115402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.