Individual provider Active NPI

John R Naegeli, PHARM. D.

  • Pharmacist
  • Cass Lake, MN
National Provider Identifier
1366673642
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
119778 Issued in MN
Practice address
425 7TH St NW
Cass Lake, MN 56633-3360
Phone
(218) 335-3267
Fax
(218) 335-3352
NPI assigned
Aug 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119778 MN Primary

Addresses

Primary practice location

425 7TH St NW
Cass Lake, MN 56633-3360

Mailing address

3500 Piper Dr NE
Bemidji, MN 56601-5417

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
119778MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1366673642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 PIPER DR NE",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3267",
            "fax_number": "218-335-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAEGELI",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cass Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.