Individual provider Active NPI

Sean Ansolabehere, PHARMD

  • Pharmacist
  • Bloomington, MN
National Provider Identifier
1396400396
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
125454 Issued in MN
Practice address
10501 Florida Ave S
Bloomington, MN 55438-2553
Phone
(952) 854-1190
NPI assigned
Nov 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 125454 MN Primary

Addresses

Primary practice location

10501 Florida Ave S
Bloomington, MN 55438-2553

Mailing address

696 Jutland Ave
Shakopee, MN 55379-3176

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
125454MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
White Drug Enterprises Inc PastSince Nov 9, 2021 Accepting new patients
Geritom Med Inc Past Accepting new patients
White Drug Enterprises Inc PastSince Nov 9, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1396400396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 JUTLAND AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 FLORIDA AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554382553",
            "telephone_number": "952-854-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSOLABEHERE",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.