Individual provider Active NPI

Jennifer Workman

  • Pharmacist
  • Detroit Lakes, MN
National Provider Identifier
1659900314
Registry record updated Apr 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
117868 Issued in MN
Practice address
329 Frazee St E
Detroit Lakes, MN 56501-3603
Phone
(218) 847-1484
Fax
(218) 847-1486
NPI assigned
Apr 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 117868 MN Primary

Addresses

Primary practice location

329 Frazee St E
Detroit Lakes, MN 56501-3603

Mailing address

329 Frazee St E
Detroit Lakes, MN 56501-3603
Phone (218) 847-1484

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

LicenseStateTypeSpecialty
117868MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand St Paul CVS LLC PastSince Apr 17, 2020 Accepting new patients
Grand St Paul CVS LLC PastSince Apr 17, 2020 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": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1659900314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 FRAZEE ST E",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013603",
            "telephone_number": "218-847-1484",
            "fax_number": "218-847-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 FRAZEE ST E",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013603",
            "telephone_number": "218-847-1484",
            "fax_number": "218-847-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKMAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; 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.