Active NPI
Ricky Alan Hurd
- Pharmacist
- Mankato, MN
National Provider Identifier
1689203358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 111706
- Practice address
- 1175 Madison Ave
Mankato, MN 56001-5227 - Phone
- (507) 625-1791
- Fax
- (507) 625-9262
- NPI assigned
- Apr 5, 2020
- Last updated
- Apr 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 111706 | MN | Primary |
Addresses
Primary practice location
1175 Madison Ave
Mankato, MN 56001-5227
Mailing address
1808 Creekside Dr NE
Owatonna, MN 55060-3973
Phone (507) 390-0007
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 |
|---|---|---|---|
| 111706 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | 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, 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": "1586044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586044800000",
"number": "1689203358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 CREEKSIDE DR NE",
"city": "OWATONNA",
"state": "MN",
"postal_code": "550603973",
"telephone_number": "507-390-0007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 MADISON AVE",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015227",
"telephone_number": "507-625-1791",
"fax_number": "507-625-9262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURD",
"first_name": "RICKY",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"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": "111706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, 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.