Active NPI
Daniel Smith
- Pharmacist
- Cottage Grove, MN
National Provider Identifier
1154929370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123676
- Practice address
- 7280 E Point Douglas Rd S
Cottage Grove, MN 55016-3016 - Phone
- (651) 458-7002
- NPI assigned
- Oct 9, 2020
- 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 | 123676 | MN | Primary |
Addresses
Primary practice location
7280 E Point Douglas Rd S
Cottage Grove, MN 55016-3016
Mailing address
7280 E Point Douglas Rd S
Cottage Grove, MN 55016-3016
Phone (651) 458-7002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123676 | Other | MN | STATE LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123676 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1154929370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7280 E POINT DOUGLAS RD S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550163016",
"telephone_number": "651-458-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7280 E POINT DOUGLAS RD S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550163016",
"telephone_number": "651-458-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-09",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123676",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "123676",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.