Active NPI
John Grygelko, PHARMD
- Pharmacist
- Bemidji, MN
National Provider Identifier
1720450604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 121402
- Practice address
- 1300 Anne St NW
Bemidji, MN 56601-5103 - Phone
- (218) 333-5541
- Fax
- (218) 333-5816
- NPI assigned
- Oct 30, 2015
- 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 | 121402 | MN | Primary |
Addresses
Primary practice location
1300 Anne St NW
Bemidji, MN 56601-5103
Mailing address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5541
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 |
|---|---|---|---|
| 121402 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446163200000",
"number": "1720450604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015103",
"telephone_number": "218-333-5541",
"fax_number": "218-333-5816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015103",
"telephone_number": "218-333-5541",
"fax_number": "218-333-5816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRYGELKO",
"first_name": "JOHN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-30",
"last_updated": "2015-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "121402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
- Great River Dentistry of Bemidji, P.a.
- Great River Dentistry of Bemidji, PLLC
- Great River Psychological Services, P.a.
- Great Western Medical Group PLLC
- Margaret Grob, PT
- Sondra L. Gudmundson, R.D.
- Ravi N Gupta, D.D.S.
- Kathrine Elizabeth Haag, RDH
- Matthew James Haffner, M.D.
- Toni J. Haffner, C.R.N.A.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.