Individual provider Active NPI

Dae Chul Yoo, PHARM.D

  • Pharmacist
  • Roseville, MN
National Provider Identifier
1154932101
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
124219 Issued in MN
Practice address
2750 Arthur St
Roseville, MN 55113-1303
Phone
(651) 635-9272
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 124219 MN Primary

Addresses

Primary practice location

2750 Arthur St
Roseville, MN 55113-1303

Mailing address

2750 Arthur St
Roseville, MN 55113-1303
Phone (651) 635-9272

Other practice location 1

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422-4286
Phone (763) 588-2750

Other practice location 2

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8849

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
124219MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Aug 1, 2020 Accepting new patients
Walgreen Co PastSince Aug 1, 2020 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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1154932101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 ARTHUR ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131303",
            "telephone_number": "651-635-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 ARTHUR ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131303",
            "telephone_number": "651-635-9272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Hidden Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554224286",
            "country_code": "US",
            "telephone_number": "763-588-2750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Smith Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022344",
            "country_code": "US",
            "telephone_number": "651-241-8849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOO",
        "first_name": "DAE CHUL",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.