Individual provider Active NPI

Matthew Tracy

  • Pharmacy Technician
  • Eagan, MN
National Provider Identifier
1659724474
Registry record updated Jul 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
Practice address
2795 Pilot Knob Rd
Eagan, MN 55121-1176
Phone
(844) 532-3456
NPI assigned
Jul 16, 2016
Last updated
Jul 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X Primary

Addresses

Primary practice location

2795 Pilot Knob Rd
Eagan, MN 55121-1176

Mailing address

3819 Jamestown Curv
Woodbury, MN 55129-4931

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

NPI Registry JSON

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

{
    "created_epoch": "1468627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1659724474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 JAMESTOWN CURV",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211176",
            "telephone_number": "844-532-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-16",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2016; 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.