Active NPI
McKenzie Johnson I, PHARM D
- Pharmacist
- Crookston, MN
National Provider Identifier
1730531856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH5868
- Practice address
- 1930 Sahlstrom Dr
Crookston, MN 56716-2819 - Phone
- (218) 281-6170
- NPI assigned
- Jul 13, 2016
- 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 | RPH5868 | ND | Primary |
Addresses
Primary practice location
1930 Sahlstrom Dr
Crookston, MN 56716-2819
Mailing address
2301 43Rd Ave S
Grand Forks, ND 58201-3460
Phone (218) 289-4037
Other practice location 1
544 Hill Ave
Grafton, ND 58237-1444
Phone (701) 352-1760
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 |
|---|---|---|---|
| RPH5868 | ND | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients | |
| White Drug Co of Jamestown Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Thrifty White Pharmacy #046
- Community/Retail Pharmacy
- West Fargo, ND
- NPI 1033208640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1730531856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 43RD AVE S",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582013460",
"telephone_number": "218-289-4037",
"fax_number": "182-816-1722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 SAHLSTROM DR",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567162819",
"telephone_number": "218-281-6170"
}
],
"practiceLocations": [
{
"address_1": "544 Hill Ave",
"address_purpose": "LOCATION",
"city": "Grafton",
"state": "ND",
"postal_code": "582371444",
"country_code": "US",
"telephone_number": "701-352-1760",
"fax_number": "701-352-1761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "MCKENZIE",
"name_suffix": "I",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-13",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "RPH5868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crookston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.