Soutsada Sandy Thongvathsa, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

123530 Issued in MN

Practice address

12011 Technology Dr
Eden Prairie, MN 55344-3620

Phone

(952) 943-4828

NPI assigned

May 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1821654377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 ESTATE DR",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433438",
            "telephone_number": "763-742-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 TECHNOLOGY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443620",
            "telephone_number": "952-943-4828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14050 Burnhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374407",
            "country_code": "US",
            "telephone_number": "952-229-6458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THONGVATHSA",
        "first_name": "SOUTSADA",
        "middle_name": "SANDY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "18851-40",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "123530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Thompson
• Lily Thompson
• Virginia Thompson
• Bernadette Thomson, BERNADETTE THOMSON
• Brent Thomson
• Shawna Dichelle Thornton-Clemons
• Emily Thrune
• Vishal Dhirajlal Thumar, MD
• Elizabeth K Tieman, M.D.
• Angela Woolf Tiesel

• Pharmacist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.