Individual provider Active NPI

Jeffrey R Bishop, PHARMD, BCPP

  • Psychiatric Pharmacist
  • St Louis Park, MN
National Provider Identifier
1225350333
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric PharmacistTaxonomy code 1835P1300X
License
122215 Issued in MN
Practice address
5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275
Phone
(612) 273-8710
Fax
(612) 273-8727
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Pharmacist 1835P1300X 122215 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275

Mailing address

5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275
Phone (612) 273-8710

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

LicenseStateTypeSpecialty
122215MNMDPsychiatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Past Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225350333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "612-273-8710",
            "fax_number": "612-273-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "612-273-8710",
            "fax_number": "612-273-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "PHARMD, BCPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "MN",
            "license": "122215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.