Active NPI
Joan L Ice, R PH
- Pharmacist
- Onamia, MN
National Provider Identifier
1407058332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 114415
- Practice address
- 43500 Migizi Dr
Onamia, MN 56359-2241 - Phone
- (320) 532-4770
- Fax
- (320) 532-4705
- NPI assigned
- Jun 4, 2007
- Last updated
- Aug 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 114415 | MN | Primary |
Addresses
Primary practice location
43500 Migizi Dr
Onamia, MN 56359-2241
Mailing address
43500 Migizi Dr
Onamia, MN 56359-2241
Phone (620) 532-4770
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114415 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406851200000",
"number": "1407058332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43500 MIGIZI DR",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563592241",
"telephone_number": "620-532-4770",
"fax_number": "320-532-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43500 MIGIZI DR",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563592241",
"telephone_number": "320-532-4770",
"fax_number": "320-532-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICE",
"first_name": "JOAN",
"middle_name": "L",
"credential": "R PH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2014-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "114415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onamia, MN
- Jennifer Lee Hewitt, RN, PHN
- Patti Jean Hook, M.D.
- Kathi Marie Hopkins, HHA
- Donna Lynn Hormillosa, RN
- Ronald John Hunt, MS, LP
- Ind School Dist 480 of Onamia (Onamia Public Schools - ISD #480)
- Christina Marie Irrgang-Wade, MA, LPCC
- Roger Jahn, RN, PHN
- Jacquline Mae Jensen, RN
- Jerome D. Poland, M.D., LTD (Crosby Eye Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.