Individual provider Active NPI

Pamela Beardslee, PHARMD

  • Pharmacist
  • Cloquet, MN
National Provider Identifier
1104468446
Registry record updated Jul 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
137688 Issued in AK
Practice address
1308 Highway 33 S
Cloquet, MN 55720-2653
Phone
(218) 878-0676
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21229-40 WI
Pharmacist 183500000X 124559 MN
Pharmacist 183500000X 137688 AK Primary

Addresses

Primary practice location

1308 Highway 33 S
Cloquet, MN 55720-2653

Mailing address

1308 Highway 33 S
Cloquet, MN 55720-2653
Phone (218) 878-0676

Other practice location 1

3705 Tower Ave
Superior, WI 54880-5338
Phone (715) 392-9520

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
137688AKMDPharmacist
124559MNMDPharmacist
21229-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince May 1, 2022 Accepting new patients
Walgreen Co PastSince Oct 1, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1104468446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 HIGHWAY 33 S",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202653",
            "telephone_number": "218-878-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 HIGHWAY 33 S",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202653",
            "telephone_number": "218-878-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 Tower Ave",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548805338",
            "country_code": "US",
            "telephone_number": "715-392-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARDSLEE",
        "first_name": "PAMELA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21229-40",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124559",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "137688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2022; 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.