Kimberly Ann Bertelsen, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

118651 Issued in MN

Practice address

822 30TH Ave S
Moorhead, MN 56560-5006

Phone

(218) 236-0807

Fax

(218) 236-4807

NPI assigned

Mar 8, 2020

Last updated

Mar 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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

• Grand St Paul CVS LLC

  dba CVS Pharmacy # 11046

  • Pharmacy
  • Plymouth, MN
  • NPI 1437620903
  NPD (past)

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

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1548895733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605006",
            "telephone_number": "218-236-0807",
            "fax_number": "218-236-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605006",
            "telephone_number": "218-236-0807",
            "fax_number": "218-236-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTELSEN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Berger
• Christen Bergeron, MS
• McKenzie Rae Bergeson
• Katie B Bergh, M.S.
• Jonathan Berntson
• Alexander Bertram, MS, LAT, ATC
• Taylor Lynne Bertsch
• Mariah Bestland
• Beths Place LLC
• Beths Place Medication Management LLC

• Pharmacist in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.