Individual provider Active NPI

Mikinze Jones, PHARMD

  • Pharmacist
  • Rapid City, SD
National Provider Identifier
1639794688
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6803 Issued in SD
Practice address
4503 Candlewood PL Apt 107
Rapid City, SD 57702-0190
Phone
(605) 380-0144
NPI assigned
Jun 15, 2020
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pharmacist 183500000X 6803 SD Primary

Addresses

Primary practice location

4503 Candlewood PL Apt 107
Rapid City, SD 57702-0190

Mailing address

4503 Candlewood PL Apt 107
Rapid City, SD 57702-0190
Phone (605) 380-0144

Other practice location 1

13651 387th Ave
Aberdeen, SD 57401-8505
Phone (605) 380-0144

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
6803SDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1639794688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 CANDLEWOOD PL APT 107",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020190",
            "telephone_number": "605-380-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 CANDLEWOOD PL APT 107",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020190",
            "telephone_number": "605-380-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13651 387th Ave",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574018505",
            "country_code": "US",
            "telephone_number": "605-380-0144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "MIKINZE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "6803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.