Individual provider Active NPI

Grant Matthias Heller

  • Pharmacist
  • Rochester, MN
National Provider Identifier
1497532527
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
126201 Issued in MN
Practice address
80 14TH St SW
Rochester, MN 55902-3810
Phone
(507) 206-5132
NPI assigned
Sep 12, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 126201 MN Primary

Addresses

Primary practice location

80 14TH St SW
Rochester, MN 55902-3810

Mailing address

413 Boulder Rd SE
Rochester, MN 55904-7001
Phone (507) 923-6583

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

LicenseStateTypeSpecialty
126201MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Sep 17, 2023 Accepting new patients
Walgreen Co PastSince Sep 17, 2023 Accepting new patients

Locations

80 14th St SW
Rochester, MN 55902
Phone (507) 206-5132

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1497532527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 BOULDER RD SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559047001",
            "telephone_number": "507-923-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 14TH ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023810",
            "telephone_number": "507-206-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "GRANT",
        "middle_name": "MATTHIAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "126201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.