Individual provider Active NPI

Jodi Nordstrom, PHARMD

  • Pharmacist
  • Maple Grove, MN
National Provider Identifier
1447189436
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
117743 Issued in MN
Practice address
16752 73Rd PL N
Maple Grove, MN 55311-2130
Phone
(626) 644-1163
NPI assigned
May 15, 2026
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 117743 MN Primary

Addresses

Primary practice location

16752 73Rd PL N
Maple Grove, MN 55311-2130

Mailing address

16752 73Rd PL N
Maple Grove, MN 55311-2130

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
117743MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1447189436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16752 73RD PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16752 73RD PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112130",
            "telephone_number": "626-644-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "JODI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.