Colleen Marie Mathisen

Primary specialty

PharmacistTaxonomy code 183500000X

License

115510 Issued in MN

Practice address

540 Blake Rd N
Hopkins, MN 55343-8123

Phone

(952) 938-1168

NPI assigned

Jan 4, 2021

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Hopkins, MN
  • NPI 1780699090
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1164010328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 153RD PL",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782388",
            "telephone_number": "952-201-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BLAKE RD N",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438123",
            "telephone_number": "952-938-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISEN",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "115510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Andrew Marks
• Stephanie Martin, MA
• Marty Chiropractic Hopkins P.a.
• Marty Gullickson Chiropractic
• William Luke Marty, DC
• Olivia Ann Matthys, CCC-SLP
• Michael Earl Maus, PH.D.
• Mark D McAlister, A.T.P.
• Melissa V McBorrough, RBT
• Lindsey McDougall

• Pharmacist in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.