DR. JOHN PHILLIP KOOP (NPI# 1679648414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679648414 |
| Entity Type | Individual |
| Full Name | DR. JOHN PHILLIP KOOP |
| Credential | PHARM. D. |
| Practice Address |
11800 State Ave Brainerd MN 56401-7308 |
| Practice Telephone | 2188282759 |
| Practice Fax Number | 2188282207 |
| Mailing Telephone | 2188282759 |
| Mailing Fax Number | 2188282207 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
114002-4 | MN | Pharmacy Service Providers |
| Street Address |
11800 STATE AVE |
| City | BRAINERD |
| State | MN |
| Zip Code | 56401-7308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841206901 | Susan Mary Mathison-young | Nurse Practitioner | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-07-31 |
| 1467508226 | Brainerd Dental Clinic | Dentist | 11800 State Ave, Brainerd, MN 56401-7308 | 2007-01-26 |
| 1659434744 | Susan K Dudding | Nurse Practitioner | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-12-19 |
| 1659445229 | C.a.r.e.-brainerd | Substance Abuse Rehabilitation Facility | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
| 1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
| 1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
| 1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
| 1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
| Find all providers in zip 56401 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504139 | Jacob Stevens | Pharmacist | 19216 Freeport Ave, Cub Pharmacy, Elk River, MN 55330 | 2020-07-01 |
| 1215470943 | Kaitlyn Latour | Pharmacist | 3500 County Road 39 Nw, Maple Lake, MN 55358-3019 | 2016-11-29 |
| 1124413604 | Philip Kohls | Pharmacist | 523 Lake Ave, Saint Paul, MN 55110-1631 | 2015-04-01 |
| 1346671112 | Consultant Pharmacists Inc | Pharmacist | 1413 Hoot Lake Dr, Fergus Falls, MN 56537-3953 | 2013-12-04 |
| 1215377650 | Jennifer Ann Marquart | Pharmacist | 15517 Post Rd, Wayzata, MN 55391-2116 | 2013-06-30 |
| 1174860795 | Ruonan Zhang | Pharmacist | 1925 West County Road B2, Roseville, MN 55113 | 2013-01-16 |
| 1265700991 | Ali Mahamud | Pharmacist | 681 Central Ave W, Saint Paul, MN 55104-4821 | 2011-12-08 |
| 1760767834 | Agnes Njema Azeh | Pharmacist | 99 Maryland Ave W, Saint Paul, MN 55117-4528 | 2011-10-19 |
| 1003134495 | Beth J Alexander | Pharmacist | 1302 Palace Ave, Saint Paul, MN 55105-2952 | 2010-05-10 |
| 1225279763 | Rick John Melbye | Pharmacist | 3210 Rivershore Dr, Moorhead, MN 56560-5549 | 2009-03-12 |
| Find all providers with the same taxonomy | ||||
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| 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.