Individual provider Active NPI

Mary Jo Flockhart, RPH

  • Pharmacist
  • Northfield, MN
National Provider Identifier
1780967083
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
116623-1 Issued in MN
Practice address
401 5TH St W
Northfield, MN 55057-1700
Phone
(507) 645-9658
Fax
(507) 645-9674
NPI assigned
Sep 22, 2011
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 116623-1 MN Primary

Addresses

Primary practice location

401 5TH St W
Northfield, MN 55057-1700

Mailing address

401 5TH St W
Northfield, MN 55057-1700
Phone (507) 645-9658

Other names 1

  • Miss Mary Jo Feehan Former name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
116623-1MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1780967083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 5TH ST W",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550571700",
            "telephone_number": "507-645-9658",
            "fax_number": "507-645-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 5TH ST W",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550571700",
            "telephone_number": "507-645-9658",
            "fax_number": "507-645-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOCKHART",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116623-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FEEHAN",
            "middle_name": "JO",
            "prefix": "MISS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.