Active NPI
Matthew James Just, PHARM.D.
- Pharmacist
- Plymouth, MN
National Provider Identifier
1104258300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120959
- Practice address
- 6055 Nathan LN N Ste 200
Plymouth, MN 55442-1675 - Phone
- (763) 513-4300
- NPI assigned
- Jul 30, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 120959 | MN | Primary |
Addresses
Primary practice location
6055 Nathan LN N Ste 200
Plymouth, MN 55442-1675
Mailing address
232 W Rainbow St
Duluth, MN 55811-2006
Phone (651) 600-0835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120959 | Other | MN | STATE PHARMACIST LICENSE ID |
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 |
|---|---|---|---|
| 120959 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375142400000",
"number": "1104258300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 W RAINBOW ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558112006",
"telephone_number": "651-600-0835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6055 NATHAN LN N STE 200",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554421675",
"telephone_number": "763-513-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUST",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-30",
"last_updated": "2013-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120959",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE ID",
"identifier": "120959",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.