Kevin John Westerberg

Primary specialty

PharmacistTaxonomy code 183500000X

License

114341 Issued in MN

Practice address

950 11TH St SW
Pine City, MN 55063-2113

Phone

(320) 629-6225

NPI assigned

Oct 20, 2020

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1154920304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 11TH ST SW",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550632113",
            "telephone_number": "320-629-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 11TH ST SW",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550632113",
            "telephone_number": "320-629-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERBERG",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "114341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Pine City, MN
• Providers in Pine City, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.