Active NPI
Deborah Ann Anderson, RPH
- Pharmacist
- Lakeville, MN
National Provider Identifier
1306013099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 113003
- Practice address
- 20250 Heritage Dr
Lakeville, MN 55044-6869 - Phone
- (952) 469-8404
- NPI assigned
- May 12, 2008
- Last updated
- May 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 113003 | MN | Primary |
Addresses
Primary practice location
20250 Heritage Dr
Lakeville, MN 55044-6869
Mailing address
20250 Heritage Dr
Lakeville, MN 55044-6869
Phone (952) 469-8404
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113003 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supervalu Pharmacies Inc. | Past | Accepting new patients | |
| Supervalu Pharmacies Inc | 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, 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": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210550400000",
"number": "1306013099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20250 HERITAGE DR",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550446869",
"telephone_number": "952-469-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20250 HERITAGE DR",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550446869",
"telephone_number": "952-469-8404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DEBORAH",
"middle_name": "ANN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2008-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "113003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.