Active NPI
David E Gangeness
- Pharmacist
- Cloquet, MN
National Provider Identifier
1801158175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 112792
- Practice address
- 927 Trettel LN
Cloquet, MN 55720-1345 - Phone
- (218) 879-1227
- Fax
- (218) 878-2179
- NPI assigned
- Jun 13, 2012
- 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 | 112792 | MN | Primary |
Addresses
Primary practice location
927 Trettel LN
Cloquet, MN 55720-1345
Mailing address
927 Trettel LN
Cloquet, MN 55720-1345
Phone (218) 879-1227
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112792 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339545600000",
"number": "1801158175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "927 TRETTEL LN",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201345",
"telephone_number": "218-879-1227",
"fax_number": "218-878-2179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 TRETTEL LN",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201345",
"telephone_number": "218-879-1227",
"fax_number": "218-878-2179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGENESS",
"first_name": "DAVID",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-13",
"last_updated": "2012-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "112792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.