Active NPI
Jessica Anne Cooper
- Pharmacist
- Buffalo, MN
National Provider Identifier
1871843847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 116820
- Practice address
- 1300 State Highway 55 NE
T-0861
Buffalo, MN 55313-4321 - Phone
- (763) 682-4996
- NPI assigned
- Sep 17, 2012
- Last updated
- Sep 17, 2012
- Sex
- Female
- 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 | 116820 | MN | Primary |
Addresses
Primary practice location
1300 State Highway 55 NE
T-0861
Buffalo, MN 55313-4321
Mailing address
1300 State Highway 55 NE
T-0861
Buffalo, MN 55313-4321
Phone (763) 682-4996
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 |
|---|---|---|---|
| 116820 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347840000000",
"number": "1871843847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 STATE HIGHWAY 55 NE",
"address_2": "T-0861",
"city": "BUFFALO",
"state": "MN",
"postal_code": "553134321",
"telephone_number": "763-682-4996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 STATE HIGHWAY 55 NE",
"address_2": "T-0861",
"city": "BUFFALO",
"state": "MN",
"postal_code": "553134321",
"telephone_number": "763-682-4996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "JESSICA",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-17",
"last_updated": "2012-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "116820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.