Individual provider Active NPI

Jessica Sewalson, PHARMD

  • Pharmacist
  • Coon Rapids, MN
National Provider Identifier
1770879082
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
118938 Issued in MN
Practice address
8600 Springbrook Dr NW
T-0820
Coon Rapids, MN 55433-6033
Phone
(763) 785-0720
Fax
(763) 785-0720
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 118938 MN Primary

Addresses

Primary practice location

8600 Springbrook Dr NW
T-0820
Coon Rapids, MN 55433-6033

Mailing address

8600 Springbrook Dr NW
T-0820
Coon Rapids, MN 55433-6033
Phone (763) 785-0720

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
118938MNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1770879082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SPRINGBROOK DR NW",
            "address_2": "T-0820",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554336033",
            "telephone_number": "763-785-0720",
            "fax_number": "763-785-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SPRINGBROOK DR NW",
            "address_2": "T-0820",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554336033",
            "telephone_number": "763-785-0720",
            "fax_number": "763-785-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEWALSON",
        "first_name": "JESSICA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.