Active NPI
Alyssa Louise Real, PHARMD
- Pharmacist
- Saint Peter, MN
National Provider Identifier
1710409792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123403
- Practice address
- 2008 Sunrise Dr
Saint Peter, MN 56082-5384 - Phone
- (507) 931-8707
- NPI assigned
- Jul 12, 2017
- Last updated
- Jul 24, 2024
- Sex
- Female
- 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 | 123403 | MN | Primary |
Addresses
Primary practice location
2008 Sunrise Dr
Saint Peter, MN 56082-5384
Mailing address
326 Nassau St
Saint Peter, MN 56082-2020
Phone (715) 529-0052
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
| License | State | Type | Specialty |
|---|---|---|---|
| 123403 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1710409792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 NASSAU ST",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560822020",
"telephone_number": "715-529-0052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2008 SUNRISE DR",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560825384",
"telephone_number": "507-931-8707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAL",
"first_name": "ALYSSA",
"middle_name": "LOUISE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-12",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.