Individual provider Active NPI

Julia Prokop, PHARMD

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1447846563
Registry record updated Dec 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
122822 Issued in MN
Practice address
1540 New Brighton Blvd
Minneapolis, MN 55413-1653
Phone
(612) 789-0342
Fax
(612) 789-0347
NPI assigned
Dec 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 122822 MN Primary

Addresses

Primary practice location

1540 New Brighton Blvd
Minneapolis, MN 55413-1653

Mailing address

1540 New Brighton Blvd
Minneapolis, MN 55413-1653
Phone (612) 789-0342

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
122822MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1447846563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 NEW BRIGHTON BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131653",
            "telephone_number": "612-789-0342",
            "fax_number": "612-789-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 NEW BRIGHTON BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131653",
            "telephone_number": "612-789-0342",
            "fax_number": "612-789-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOP",
        "first_name": "JULIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-13",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "122822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.