Active NPI
John Nied, PHARMD
- Pharmacist
- Coon Rapids, MN
National Provider Identifier
1174159230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122477
- Practice address
- 10930 University Ave NW
Coon Rapids, MN 55448-6120 - Phone
- (763) 755-6316
- NPI assigned
- Mar 19, 2020
- Last updated
- Mar 19, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18271 | WI | |
| Pharmacist | 183500000X | 122477 | MN | Primary |
Addresses
Primary practice location
10930 University Ave NW
Coon Rapids, MN 55448-6120
Mailing address
10930 University Ave NW
Coon Rapids, MN 55448-6120
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
| License | State | Type | Specialty |
|---|---|---|---|
| 122477 | MN | MD | Pharmacist |
| 18271 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1174159230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10930 UNIVERSITY AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554486120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10930 UNIVERSITY AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554486120",
"telephone_number": "763-755-6316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIED",
"first_name": "JOHN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-19",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18271",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.