Active NPI
Samantha Jo Knudson
- Pharmacist
- Fergus Falls, MN
National Provider Identifier
1477379220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 126715
- Practice address
- 712 S Cascade St
Fergus Falls, MN 56537-2913 - Phone
- (218) 736-8000
- Fax
- (218) 736-8787
- NPI assigned
- Nov 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH6610 | ND | |
| Pharmacist | 183500000X | 126715 | MN | Primary |
Addresses
Primary practice location
712 S Cascade St
Fergus Falls, MN 56537-2913
Mailing address
533 E Summit St
Battle Lake, MN 56515-4113
Phone (218) 770-8906
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126715 | MN | MD | Pharmacist |
| RPH6610 | ND | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1477379220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 E SUMMIT ST",
"city": "BATTLE LAKE",
"state": "MN",
"postal_code": "565154113",
"telephone_number": "218-770-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 S CASCADE ST",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372913",
"telephone_number": "218-736-8000",
"fax_number": "218-736-8787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSON",
"first_name": "SAMANTHA",
"middle_name": "JO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "RPH6610",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "126715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.