Active NPI
Caitlin Pederson
- Pharmacist
- Glenwood, MN
National Provider Identifier
1558868554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123384
- Practice address
- 7 4TH Ave SE
Glenwood, MN 56334-1879 - Phone
- (320) 634-4434
- Fax
- (320) 634-5632
- NPI assigned
- Apr 7, 2018
- Last updated
- Apr 7, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 123384 | MN | Primary |
Addresses
Primary practice location
7 4TH Ave SE
Glenwood, MN 56334-1879
Mailing address
PO Box 198
Glenwood, MN 56334-0198
Phone (320) 634-4434
Other names 1
- Caitlin Peterson
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 |
|---|---|---|---|
| 123384 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trumm Drug, Inc. | Past | Accepting new patients | |
| Trumm Drug, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523059200000",
"number": "1558868554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198",
"city": "GLENWOOD",
"state": "MN",
"postal_code": "563340198",
"telephone_number": "320-634-4434",
"fax_number": "320-634-5632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 4TH AVE SE",
"city": "GLENWOOD",
"state": "MN",
"postal_code": "563341879",
"telephone_number": "320-634-4434",
"fax_number": "320-634-5632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSON",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-07",
"last_updated": "2018-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAITLIN",
"last_name": "PETERSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Glenwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.