Individual provider Active NPI

Pamela Lynn Nelson, PHARM.D.

  • Pharmacist
  • Bloomington, MN
National Provider Identifier
1417976895
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
116573 Issued in MN
Practice address
8936 Lyndale Ave S
Bloomington, MN 55420-2742
Phone
(952) 881-0163
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 116573-7 MN
Pharmacist 183500000X 116573 MN Primary

Addresses

Primary practice location

8936 Lyndale Ave S
Bloomington, MN 55420-2742

Mailing address

8132 W 103Rd St
Bloomington, MN 55438-1969
Phone (952) 380-5970

Other practice location 1

800 W 78th St
Chanhassen, MN 55317-9578
Phone (952) 380-5970

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
116573MNMDPharmacist
116573-7MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1417976895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8132 W 103RD ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381969",
            "telephone_number": "952-380-5970",
            "fax_number": "952-401-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202742",
            "telephone_number": "952-881-0163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W 78th St",
            "address_purpose": "LOCATION",
            "city": "Chanhassen",
            "state": "MN",
            "postal_code": "553179578",
            "country_code": "US",
            "telephone_number": "952-380-5970",
            "fax_number": "952-401-9002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116573-7",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116573",
            "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 Dec 30, 2020; 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.