Daniel Frederick Bohmer, RPH – Pharmacist

Key facts

NPI: 1356313019
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 4495 (ND)
Practice address: 3000 32ND Ave S
Pharmacy Department
Fargo, ND 58103-6132
Phone: (701) 364-8143
Fax: (701) 364-8157
NPI assigned: Feb 6, 2006
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
115414-6	MN	MD	Pharmacist
4495	ND	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	4495	ND	Yes
Pharmacist	183500000X	115414-6	MN

Addresses

Primary practice location

3000 32ND Ave S
Pharmacy Department
Fargo, ND 58103-6132

Mailing address

515 30TH St N
Moorhead, MN 56560-2561
Phone (701) 388-5547

Other identifiers

Identifier	Type	State	Issuer
115414-6	Other	MN	PHARMACIST LICENSE
4495	Other	ND	PHARMACIST LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356313019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 30TH ST N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602561",
            "telephone_number": "701-388-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8143",
            "fax_number": "701-364-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHMER",
        "first_name": "DANIEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "4495",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "115414-6",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "115414-6",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "4495",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

All providers in Fargo, ND · Pharmacist in North Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.