Active NPI
Matthew Paul Lillyblad, PHARMD
- Pharmacist
- Minneapolis, MN
National Provider Identifier
1982955084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 120017
- Practice address
- 701 Park Ave
HCMC Inpatient Pharmacy- Red Lower Level
Minneapolis, MN 55415-1623 - Phone
- (612) 873-4523
- Fax
- (612) 904-4286
- NPI assigned
- Sep 28, 2012
- 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 | 120017 | MN | Primary |
Addresses
Primary practice location
701 Park Ave
HCMC Inpatient Pharmacy- Red Lower Level
Minneapolis, MN 55415-1623
Mailing address
701 Park Ave
HCMC Inpatient Pharmacy- Red Lower Level
Minneapolis, MN 55415-1623
Phone (612) 873-4523
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 |
|---|---|---|---|
| 120017 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1982955084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"address_2": "HCMC INPATIENT PHARMACY- RED LOWER LEVEL",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-4523",
"fax_number": "612-904-4286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"address_2": "HCMC INPATIENT PHARMACY- RED LOWER LEVEL",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-4523",
"fax_number": "612-904-4286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLYBLAD",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "120017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.