Active NPI
Rachel Grimm
- Pharmacist
- Andover, MN
National Provider Identifier
1356715635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 115298
- Practice address
- 2000 Bunker Lake Blvd NW
Andover, MN 55304-4014 - Phone
- (763) 852-0114
- NPI assigned
- Nov 24, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 115298 | MN | Primary |
Addresses
Primary practice location
2000 Bunker Lake Blvd NW
Andover, MN 55304-4014
Mailing address
15384 Wintergreen St NW
Andover, MN 55304-7737
Phone (763) 432-5052
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
| License | State | Type | Specialty |
|---|---|---|---|
| 115298 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448323200000",
"number": "1356715635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15384 WINTERGREEN ST NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "553047737",
"telephone_number": "763-432-5052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 BUNKER LAKE BLVD NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "553044014",
"telephone_number": "763-852-0114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "RACHEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-24",
"last_updated": "2015-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "115298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.