Individual provider Active NPI

Kathleen Marie Nelson, R.PH

  • Pharmacist
  • Casselton, ND
National Provider Identifier
1902116734
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4278 Issued in ND
Practice address
622 Front St
Casselton, ND 58012-3300
Phone
(701) 347-4281
Fax
(701) 347-5275
NPI assigned
Oct 14, 2010
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4278 ND Primary

Addresses

Primary practice location

622 Front St
Casselton, ND 58012-3300

Mailing address

PO Box 250
Casselton, ND 58012-0250
Phone (701) 347-4281

Other identifiers 1

IdentifierTypeStateIssuer
4278OtherNDND STATE BOARD OF PHARMACY LIC NUMBER

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
4278NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Casselton Drug Inc. Current Accepting new patients
Casselton Drug Inc Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1902116734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "CASSELTON",
            "state": "ND",
            "postal_code": "580120250",
            "telephone_number": "701-347-4281",
            "fax_number": "701-347-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 FRONT ST",
            "city": "CASSELTON",
            "state": "ND",
            "postal_code": "580123300",
            "telephone_number": "701-347-4281",
            "fax_number": "701-347-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "4278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND STATE BOARD OF PHARMACY LIC NUMBER",
            "identifier": "4278",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselton, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.