Active NPI
Valerie Halverson, R.PH.
- Pharmacist
- Grand Rapids, MN
National Provider Identifier
1174740849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 116120
- Practice address
- 2410 S Pokegama Ave
Grand Rapids, MN 55744-2503 - Phone
- (218) 326-9089
- Fax
- (218) 326-9525
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- 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 | 116120 | MN | Primary |
Addresses
Primary practice location
2410 S Pokegama Ave
Grand Rapids, MN 55744-2503
Mailing address
43935 Forestry Rd
Bovey, MN 55709-5527
Phone (218) 327-9527
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116120 | Other | MN | PHARMACIST LICENSE NUMBER |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116120 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174740849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43935 FORESTRY RD",
"city": "BOVEY",
"state": "MN",
"postal_code": "557095527",
"telephone_number": "218-327-9527",
"fax_number": "218-326-9525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 S POKEGAMA AVE",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557442503",
"telephone_number": "218-326-9089",
"fax_number": "218-326-9525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVERSON",
"first_name": "VALERIE",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "116120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "116120",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, 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.