Individual provider Active NPI

Steven Paul Boyd, R.PH

  • Pharmacist
  • Moorhead, MN
National Provider Identifier
1609145341
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
114115 Issued in MN
Practice address
900 Main Ave
Moorhead, MN 56560-2802
Phone
(218) 236-0252
NPI assigned
Dec 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 114115 MN Primary

Addresses

Primary practice location

900 Main Ave
Moorhead, MN 56560-2802

Mailing address

34 40TH Avenue Oak Cir S
Moorhead, MN 56560-5610
Phone (701) 367-5536

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
114115MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Mar 6, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1609145341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 40TH AVENUE OAK CIR S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605610",
            "telephone_number": "701-367-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN AVE",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602802",
            "telephone_number": "218-236-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "STEVEN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "114115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; 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.