Active NPI
David Brian Willenbring
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1164580023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 113111-4
- Practice address
- 1685 Rice St
Saint Paul, MN 55113-6802 - Phone
- (651) 488-0251
- NPI assigned
- Dec 4, 2006
- 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 | 113111-4 | MN | Primary |
Addresses
Primary practice location
1685 Rice St
Saint Paul, MN 55113-6802
Mailing address
484 Chandler CT
Shoreview, MN 55126-6001
Phone (651) 484-8604
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 |
|---|---|---|---|
| 113111-4 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164580023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 CHANDLER CT",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551266001",
"telephone_number": "651-484-8604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1685 RICE ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551136802",
"telephone_number": "651-488-0251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLENBRING",
"first_name": "DAVID",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "113111-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.