Individual provider Active NPI

Jonathan Funk

  • Pharmacist
  • Bismarck, ND
National Provider Identifier
1184163941
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH5704 Issued in ND
Practice address
525 S 3Rd St
Bismarck, ND 58504-5524
Phone
(701) 255-1335
NPI assigned
Feb 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH5704 ND Primary

Addresses

Primary practice location

525 S 3Rd St
Bismarck, ND 58504-5524

Mailing address

525 S 3Rd St
Bismarck, ND 58504-5524
Phone (701) 255-1335

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

LicenseStateTypeSpecialty
RPH5704NDMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1184163941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S 3RD ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045524",
            "telephone_number": "701-255-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 3RD ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045524",
            "telephone_number": "701-255-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH5704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.