Active NPI
Anders Christen Johnson
- Pharmacist
- Stevensville, MT
National Provider Identifier
1205474780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3962
- Practice address
- 301 Main St
Stevensville, MT 59870-2597 - Phone
- (406) 777-5591
- Fax
- (406) 777-5451
- NPI assigned
- Dec 16, 2019
- Last updated
- Nov 27, 2023
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3962 | MT | Primary |
Addresses
Primary practice location
301 Main St
Stevensville, MT 59870-2597
Mailing address
12780 Conestoga Way
Lolo, MT 59847-8475
Phone (406) 544-6089
Other practice location 1
301 Main St
Stevensville, MT 59870-2531
Phone (406) 777-5591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81-1193183 | Medicaid | MT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.familypharmacist.com | Valley Drug Inc |
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 |
|---|---|---|---|
| 3962 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1205474780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12780 CONESTOGA WAY",
"city": "LOLO",
"state": "MT",
"postal_code": "598478475",
"telephone_number": "406-544-6089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 MAIN ST",
"city": "STEVENSVILLE",
"state": "MT",
"postal_code": "598702597",
"telephone_number": "406-777-5591",
"fax_number": "406-777-5451"
}
],
"practiceLocations": [
{
"address_1": "301 Main St",
"address_purpose": "LOCATION",
"city": "Stevensville",
"state": "MT",
"postal_code": "598702531",
"country_code": "US",
"telephone_number": "406-777-5591",
"fax_number": "406-777-5451",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANDERS",
"middle_name": "CHRISTEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2023-11-27",
"certification_date": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "3962",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81-1193183",
"state": "MT"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.familypharmacist.com",
"affiliation": "Y",
"endpointDescription": "website",
"affiliationName": "Valley Drug Inc",
"address_1": "301 Main St",
"city": "Stevensville",
"state": "MT",
"country_code": "US",
"postal_code": "598702597",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stevensville, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.