Patrick Awa

Primary specialty

PharmacistTaxonomy code 183500000X

License

124704 Issued in MN

Practice address

4848 County Road 101
Minnetonka, MN 55345-2635

Phone

(952) 401-3814

NPI assigned

Oct 19, 2020

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1831798248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 AMERICAN BLVD W APT 436",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371485",
            "telephone_number": "701-610-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452635",
            "telephone_number": "952-401-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWA",
        "first_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "monitor",
            "affiliation": "N",
            "endpointDescription": "visual",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4848 County Road 101",
            "city": "Minnetonka",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553452635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.