Active NPI
Stephanie Mohan, PHARMD
- Pediatric Pharmacist
- Minneapolis, MN
National Provider Identifier
1184345746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pharmacist
- License
- 124399
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Phone
- (612) 273-2404
- NPI assigned
- Sep 12, 2022
- 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 |
|---|---|---|---|---|
| Pediatric Pharmacist | 1835P0200X | 124399 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Mailing address
1929 Green Ash Dr
Carver, MN 55315-4611
Phone (262) 806-2001
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | stephanie.mohan@fairview.org | Direct |
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 |
|---|---|---|---|
| 124399 | MN | MD | Pediatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1184345746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1929 GREEN ASH DR",
"city": "CARVER",
"state": "MN",
"postal_code": "553154611",
"telephone_number": "262-806-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-273-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAN",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pediatrics",
"state": "MN",
"license": "124399",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "stephanie.mohan@fairview.org",
"affiliation": "N",
"endpointDescription": "Encrypted email address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2450 Riverside Ave",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554541450",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.