Individual provider Active NPI

Jessica Lynn Gerhartz, PHARM D

  • Pharmacist
  • St Louis Park, MN
National Provider Identifier
1447546635
Registry record updated Jun 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
119303 Issued in MN
Practice address
4124 Toledo Ave S
St Louis Park, MN 55416-3207
Phone
(218) 349-9360
NPI assigned
Jun 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119303 MN Primary

Addresses

Primary practice location

4124 Toledo Ave S
St Louis Park, MN 55416-3207

Mailing address

4124 Toledo Ave S
St Louis Park, MN 55416-3207
Phone (218) 349-9360

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
119303MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309046400000",
    "number": "1447546635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 TOLEDO AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163207",
            "telephone_number": "218-349-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 TOLEDO AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163207",
            "telephone_number": "218-349-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHARTZ",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-26",
        "last_updated": "2011-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2011; 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.