DR. JASON RYAN WACHTL (NPI# 1558507558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558507558 |
| Entity Type | Individual |
| Full Name | DR. JASON RYAN WACHTL |
| Credential | PHARM.D., BCACP, CGP |
| Practice Address |
10501 Florida Ave S Bloomington MN 55438-2553 |
| Practice Telephone | 9528541190 |
| Practice Fax Number | 9528541082 |
| Mailing Telephone | 9528541190 |
| Mailing Fax Number | 9528541082 |
| Enumeration Date | 2008-12-21 |
| Last Update Date | 2014-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 119029 | MN | Pharmacy Service Providers |
| Street Address |
10501 FLORIDA AVE S |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55438-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621193 | Geritom Med Inc | Durable Medical Equipment & Medical Supplies | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2005-10-05 |
| 1144769118 | Clarice Olson | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2017-02-23 |
| 1467991422 | Jon Evenson | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2017-02-22 |
| 1962941906 | John Stites | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2017-02-22 |
| 1689113623 | Laura L Mahlendorf | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2017-02-22 |
| 1073993622 | Jacqueline Larson | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2015-06-08 |
| 1245672740 | Brittany Kantar | Pharmacist | 10501 Florida Ave S, Bloomington, MN 55438-2553 | 2013-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912425570 | Angela Marie Gilbert | Registered Nurse | 10700 Brunswick Rd Unit 316, Bloomington, MN 55438 | 2017-09-05 |
| 1609905686 | Marypat Habermas | Pharmacist | 7349 Bush Lake Dr, Bloomington, MN 55438 | 2007-03-05 |
| 1629564620 | Andrea Jean Hegland | Pharmacist | One Veterans Drive, Pharmacy Service (119), Minneapolis, MN 55438 | 2018-07-03 |
| 1861050197 | Dustin James Javers | Physical Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2019-06-01 |
| 1285156240 | Dawn Marie Johnson | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2017-07-12 |
| 1154777654 | Jennifer Bean | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2016-05-13 |
| 1831588250 | Sia Bacas Langum | Occupational Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2015-01-22 |
| 1073948576 | Kathleen Ann Linnan Rudgers | Physical Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-09-04 |
| 1508201211 | Barbara Ann Spleiss | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-05-08 |
| 1194160895 | Patty Norby | Physical Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-05-08 |
| Find all providers in zip 55438 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558980813 | Ambika Soni | Pharmacist | 2103 N Veterans Pkwy Unit 3, Bloomington, IL 61704-0908 | 2020-04-15 |
| 1548805104 | Jasjeet Singh Waraitch | Pharmacist | 2650 S Walnut St, Bloomington, IN 47401-7302 | 2019-11-07 |
| 1740791250 | Sara Vande Walle | Pharmacist | 8400 Normandale Lake Blvd Ste 700, Bloomington, MN 55437-3810 | 2017-10-24 |
| 1487171682 | Brenden James King | Pharmacist | 645 S Rogers St Ste C, Bloomington, IN 47403-2353 | 2017-08-28 |
| 1356897391 | Brittany Ann Oliver | Pharmacist | 800 N Smith Rd, Apt G11, Bloomington, IN 47408-2928 | 2016-08-30 |
| 1073987152 | Christopher Bennett | Pharmacist | 48 Pebblebrook Ct, Bloomington, IL 61705-6300 | 2015-11-30 |
| 1912374505 | Alphonsus M Brady | Pharmacist | 2510 E Washington St, Apt #13, Bloomington, IL 61704-4447 | 2015-08-31 |
| 1376928853 | Cory Patterson | Pharmacist | 2104 Hackberry Rd, Bloomington, IL 61704-2788 | 2015-07-24 |
| 1689062671 | Lester Burris II | Pharmacist | 2424 S Walnut St, Bloomington, IN 47401-7730 | 2014-12-30 |
| 1053718510 | Dhaval H Patel | Pharmacist | 2001 S Morris Ave, 16, Bloomington, IL 61704-7293 | 2014-11-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55438 |
Please comment or provide details below to improve the information on DR. JASON RYAN WACHTL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.