Medication Management Services

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

116988 Issued in MN

Legal business name

MEDICATION MANAGEMENT SERVICES

Practice address

14442 Riverbend TRL
Thief River Falls, MN 56701-8433

Phone

(218) 681-1750

NPI assigned

Feb 18, 2009

Last updated

Feb 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jan E Pederson, PHARM.D.NPI 1295851228

Title

Pharm.D./Owner

Phone

(218) 686-5562

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jan E. Pederson, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Thief River Falls, MN
  • NPI 1295851228
  Authorized official Same address or phone

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1407095250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14442 RIVERBEND TRL",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567018433",
            "telephone_number": "218-686-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14442 RIVERBEND TRL",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567018433",
            "telephone_number": "218-681-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICATION MANAGEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "PEDERSON",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHARM.D./OWNER",
        "authorized_official_telephone_number": "218-686-5562",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "116988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1295851228",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743688200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evans O Magambo, MD
• Peyton Michelle Manecke, PHARMD
• Jennifer Ann Manning, LICSW
• Mary McEnelly, PA C
• Denise L McSherry, DO
• Katie Mercure, PT, DPT
• Mickelson Eye Clinic, PA
• Craig Roberts Mickelson, O.D.
• Thomas Carl Mickelson, D.C.
• Midwest Vision Centers Inc (Midwest Vision Centers)

• Pharmacotherapy Pharmacist in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Pharmacotherapy Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.