Active NPI
Jeffrey Mikkelson, PHARMD
- Pharmacist
- Marshall, MN
National Provider Identifier
1841898343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120370
- Practice address
- 1221 E Main St
Marshall, MN 56258-2582 - Phone
- (507) 532-9198
- Fax
- (507) 532-2079
- NPI assigned
- Oct 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 120370 | MN | Primary |
Addresses
Primary practice location
1221 E Main St
Marshall, MN 56258-2582
Mailing address
1111 Washington Ave
Marshall, MN 56258-1957
Phone (507) 380-1815
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
| License | State | Type | Specialty |
|---|---|---|---|
| 120370 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1841898343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 WASHINGTON AVE",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562581957",
"telephone_number": "507-380-1815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 E MAIN ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562582582",
"telephone_number": "507-532-9198",
"fax_number": "507-532-2079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKKELSON",
"first_name": "JEFFREY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.