Individual provider Active NPI

Matthew Volquardsen

  • Pharmacist
  • Devils Lake, ND
National Provider Identifier
1285250464
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH6213 Issued in ND
Practice address
323 5TH St NE Ste 2
Devils Lake, ND 58301-2476
Phone
(701) 662-3022
NPI assigned
Jun 23, 2020
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH6213 ND Primary

Addresses

Primary practice location

323 5TH St NE Ste 2
Devils Lake, ND 58301-2476

Mailing address

3783 S 16TH St Apt 128
Grand Forks, ND 58201-5333

Other practice location 1

737 W 12th St
Grafton, ND 58237-2117
Phone (701) 352-1760

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
RPH6213NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
White Drug Co of Jamestown Inc Past Accepting new patients
White Drug Co of Jamestown Inc PastSince Jun 28, 2020 Accepting new patients
White Drug Co of Jamestown Inc PastSince Jun 28, 2020 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1285250464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3783 S 16TH ST APT 128",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 5TH ST NE STE 2",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012476",
            "telephone_number": "701-662-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "737 W 12th St",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "ND",
            "postal_code": "582372117",
            "country_code": "US",
            "telephone_number": "701-352-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLQUARDSEN",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.