Active NPI
Benjamin Clemenson
- Pharmacist
- Saint Cloud, MN
National Provider Identifier
1932988979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 126231
- Practice address
- 1921 Coborn Blvd
Saint Cloud, MN 56301-2100 - Phone
- (320) 534-2754
- Fax
- (320) 203-1095
- NPI assigned
- Sep 28, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 126231 | MN | Primary |
Addresses
Primary practice location
1921 Coborn Blvd
Saint Cloud, MN 56301-2100
Mailing address
1921 Coborn Blvd
Saint Cloud, MN 56301-2100
Phone (320) 534-2754
Other practice location 1
113 Waite Ave S
Waite Park, MN 56387-1348
Phone (320) 259-1148
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 |
|---|---|---|---|
| 126231 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1932988979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 COBORN BLVD",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563012100",
"telephone_number": "320-534-2754",
"fax_number": "320-203-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 COBORN BLVD",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563012100",
"telephone_number": "320-534-2754",
"fax_number": "320-203-1095"
}
],
"practiceLocations": [
{
"address_1": "113 Waite Ave S",
"address_purpose": "LOCATION",
"city": "Waite Park",
"state": "MN",
"postal_code": "563871348",
"country_code": "US",
"telephone_number": "320-259-1148",
"fax_number": "320-259-1334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEMENSON",
"first_name": "BENJAMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-28",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "126231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.