Active NPI
Mikal Rutten, PHARMD
- Pharmacotherapy Pharmacist
- Saint Paul, MN
National Provider Identifier
1346584737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 121070
- Practice address
- 640 Jackson St
Mail Stop 12101B
Saint Paul, MN 55101-2502 - Phone
- (651) 254-1550
- NPI assigned
- Nov 26, 2012
- Last updated
- Nov 26, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 121070 | MN | Primary |
Addresses
Primary practice location
640 Jackson St
Mail Stop 12101B
Saint Paul, MN 55101-2502
Mailing address
1701 Century Cir
Apt #106
Woodbury, MN 55125-2193
Phone (307) 760-9094
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
| License | State | Type | Specialty |
|---|---|---|---|
| 121070 | MN | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1346584737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 CENTURY CIR",
"address_2": "APT #106",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252193",
"telephone_number": "307-760-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 JACKSON ST",
"address_2": "MAIL STOP 12101B",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551012502",
"telephone_number": "651-254-1550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTTEN",
"first_name": "MIKAL",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-26",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MN",
"license": "121070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.