Individual provider Active NPI

Jeremy T Boehme, PHARMD

  • Ambulatory Care Pharmacist
  • Fort Snelling, MN
National Provider Identifier
1376829341
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
P6533 Issued in ID
Practice address
1 Federal Dr
Fort Snelling, MN 55111-4080
Phone
(612) 467-7901
NPI assigned
Oct 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X P6533 ID
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X P6533 ID
Ambulatory Care Pharmacist 1835P2201X P6533 ID Primary
Pharmacist 183500000X P6533 ID

Addresses

Primary practice location

1 Federal Dr
Fort Snelling, MN 55111-4080

Mailing address

2700A College Dr
Rice Lake, WI 54868-2449
Phone (715) 236-2676

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
P6533IDMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1376829341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700A COLLEGE DR",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548682449",
            "telephone_number": "715-236-2676",
            "fax_number": "715-236-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FEDERAL DR",
            "city": "FORT SNELLING",
            "state": "MN",
            "postal_code": "551114080",
            "telephone_number": "612-467-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHME",
        "first_name": "JEREMY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-22",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "ID",
            "license": "P6533",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "ID",
            "license": "P6533",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "ID",
            "license": "P6533",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Snelling, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.