Active NPI
Cherryl Oloo Ouma
- Pharmacist
- Blaine, MN
National Provider Identifier
1659191724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 126708
- Practice address
- 10905 Ulysses St NE
Blaine, MN 55434-3827 - Phone
- (763) 252-0687
- Fax
- (763) 252-0693
- NPI assigned
- Oct 14, 2024
- Last updated
- Oct 14, 2024
- Sex
- Male
- 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 | 126708 | MN | Primary |
Addresses
Primary practice location
10905 Ulysses St NE
Blaine, MN 55434-3827
Mailing address
929 Portland Ave Apt 1902
Minneapolis, MN 55404-1269
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 |
|---|---|---|---|
| 126708 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
10905 Ulysses St NE
Blaine, MN 55434
Phone (763) 252-0687
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": "1728864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728864000000",
"number": "1659191724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 PORTLAND AVE APT 1902",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554041269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10905 ULYSSES ST NE",
"city": "BLAINE",
"state": "MN",
"postal_code": "554343827",
"telephone_number": "763-252-0687",
"fax_number": "763-252-0693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUMA",
"first_name": "CHERRYL",
"middle_name": "OLOO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-14",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "126708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.