Active NPI
Joseph John Bergstad, CPHT
- Pharmacy Technician
- Lakeville, MN
National Provider Identifier
1174864508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 716705
- Practice address
- 7560 160TH St W
Lakeville, MN 55044-8348 - Phone
- (952) 891-1167
- Fax
- (952) 891-3337
- NPI assigned
- Mar 11, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 716705 | MN | Primary |
Addresses
Primary practice location
7560 160TH St W
Lakeville, MN 55044-8348
Mailing address
7560 160TH St W
Lakeville, MN 55044-8348
Phone (952) 891-1167
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 |
|---|---|---|---|
| 716705 | MN | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1174864508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7560 160TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550448348",
"telephone_number": "952-891-1167",
"fax_number": "952-891-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7560 160TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550448348",
"telephone_number": "952-891-1167",
"fax_number": "952-891-3337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGSTAD",
"first_name": "JOSEPH",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MN",
"license": "716705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.