Individual provider Active NPI

Heather Sue Johnson, PHARMD

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1316232960
Registry record updated May 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
119738 Issued in MN
Practice address
711 Kasota Ave SE
Minneapolis, MN 55414-2842
Phone
(651) 357-0570
NPI assigned
Jun 11, 2011
Last updated
May 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119738 MN Primary

Addresses

Primary practice location

711 Kasota Ave SE
Minneapolis, MN 55414-2842

Mailing address

711 Kasota Ave SE
Minneapolis, MN 55414-2842

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
119738MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338163200000",
    "number": "1316232960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842",
            "telephone_number": "651-357-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-11",
        "last_updated": "2012-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 May 28, 2012; 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.