Active NPI
Adam Miller
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1679973168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 121904
- Practice address
- 1585 Randolph Ave
Saint Paul, MN 55105-2149 - Phone
- (651) 698-6502
- Fax
- (651) 698-4834
- NPI assigned
- Sep 3, 2014
- 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 | 121904 | MN | Primary |
Addresses
Primary practice location
1585 Randolph Ave
Saint Paul, MN 55105-2149
Mailing address
6817 Buckingham Rd
Woodbury, MN 55125-3818
Phone (651) 340-6999
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 |
|---|---|---|---|
| 121904 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1679973168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6817 BUCKINGHAM RD",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551253818",
"telephone_number": "651-340-6999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 RANDOLPH AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052149",
"telephone_number": "651-698-6502",
"fax_number": "651-698-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-03",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "121904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.