Active NPI
Jodie Trites, PHARMACIST
- Pharmacist
- Perham, MN
National Provider Identifier
1174001648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117535
- Practice address
- 1000 Coney St W
Perham, MN 56573-2102 - Phone
- (218) 347-1570
- Fax
- (218) 347-1574
- NPI assigned
- Aug 6, 2018
- Last updated
- Aug 6, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 117535 | MN | Primary |
Addresses
Primary practice location
1000 Coney St W
Perham, MN 56573-2102
Mailing address
1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1570
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 |
|---|---|---|---|
| 117535 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533513600000",
"number": "1174001648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CONEY ST W",
"city": "PERHAM",
"state": "MN",
"postal_code": "565732102",
"telephone_number": "218-347-1570",
"fax_number": "218-347-1574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 CONEY ST W",
"city": "PERHAM",
"state": "MN",
"postal_code": "565732102",
"telephone_number": "218-347-1570",
"fax_number": "218-347-1574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRITES",
"first_name": "JODIE",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-06",
"last_updated": "2018-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perham, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.