Individual provider Active NPI

Rachel Patrice Balk

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1720863335
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
126241 Issued in MN
Practice address
711 Kasota Ave SE
Minneapolis, MN 55414-2842
Phone
(612) 816-4059
NPI assigned
Aug 30, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 126241 MN Primary
Ambulatory Care Pharmacist 1835P2201X 126241 MN

Addresses

Primary practice location

711 Kasota Ave SE
Minneapolis, MN 55414-2842

Mailing address

2677 Borden Way
Inver Grove Heights, MN 55076-2063
Phone (612) 816-4059

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

LicenseStateTypeSpecialty
126241MNMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1720863335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 BORDEN WAY",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550762063",
            "telephone_number": "612-816-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842",
            "telephone_number": "612-816-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALK",
        "first_name": "RACHEL",
        "middle_name": "PATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "126241",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MN",
            "license": "126241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.