Individual provider Active NPI

Jared Thorsness, PHARMD

  • Pharmacist
  • Bloomington, MN
National Provider Identifier
1699113670
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
120844 Issued in MN
Practice address
2555 W 79TH St
T0005
Bloomington, MN 55431-1250
Phone
(952) 888-4677
Fax
(952) 356-3921
NPI assigned
Jun 12, 2013
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 120844 MN Primary

Addresses

Primary practice location

2555 W 79TH St
T0005
Bloomington, MN 55431-1250

Mailing address

2555 West 79TH St
T0005
Bloomington, MN 55431
Phone (952) 888-4677

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
120844MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1699113670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 WEST 79TH ST",
            "address_2": "T0005",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55431",
            "telephone_number": "952-888-4677",
            "fax_number": "952-356-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 W 79TH ST",
            "address_2": "T0005",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311250",
            "telephone_number": "952-888-4677",
            "fax_number": "952-356-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSNESS",
        "first_name": "JARED",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "120844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.