Individual provider Active NPI

Sara Fiskum, PHARM. D.

  • Pharmacist
  • Woodbury, MN
National Provider Identifier
1528310562
Registry record updated Oct 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
121100 Issued in MN
Practice address
7200 Valley Creek PLZ
T-0694
Woodbury, MN 55125-2265
Phone
(651) 735-9517
NPI assigned
Oct 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 121100 MN Primary

Addresses

Primary practice location

7200 Valley Creek PLZ
T-0694
Woodbury, MN 55125-2265

Mailing address

7200 Valley Creek PLZ
T-0694
Woodbury, MN 55125-2265

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
121100MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1350172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350172800000",
    "number": "1528310562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 VALLEY CREEK PLZ",
            "address_2": "T-0694",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 VALLEY CREEK PLZ",
            "address_2": "T-0694",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252265",
            "telephone_number": "651-735-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISKUM",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-14",
        "last_updated": "2012-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "121100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2012; 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.