KAYLEE DITTBERNER (NPI# 1225636111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225636111 |
| Entity Type | Individual |
| Full Name | KAYLEE DITTBERNER |
| Other Name | KAYLEE SOMMER |
| Credential | RPH, PHARMD |
| Practice Address |
5815 Norell Ave N Oak Park Heights MN 55082-1766 |
| Mailing Address |
1338 Griffin Ave Mahtomedi MN 55115-1903 |
| Practice Telephone | 6514397630 |
| Mailing Telephone | 6517926528 |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
123446 | MN | Pharmacy Service Providers |
| Street Address |
5815 NORELL AVE N |
| City | OAK PARK HEIGHTS |
| State | MN |
| Zip Code | 55082-1766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457378838 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2006-07-16 |
| 1396343364 | Kevin Matkaiti | Pharmacist | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2020-10-13 |
| 1932447190 | John Lomnicki Sr. | Pharmacist | 5815 Norell Ave N, Oak Park Heights, MN 55082 | 2013-01-23 |
| 1679860811 | Visionary Optical LLC | Optometrist | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2011-07-08 |
| 1598099772 | Stillwater Medical Group | Physician Assistant | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2009-09-22 |
| 1700919883 | Wal-mart Stores, Inc. | Technician/Technologist | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2007-03-14 |
| 1760555767 | Chepulis Family Eye Care, Inc. | Optometrist | 5815 Norell Ave N, Oak Park Heights, MN 55082-1766 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
| 1174160832 | Susan Jacobson | Pharmacist | One Veterans Drive (119), Minneapolis, MN 55417 | 2019-12-02 |
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
| 1922479062 | Shelby Setniker-eschiti | Pharmacist | 2172 German St, Maplewood, MN 55109-2853 | 2015-10-15 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1104259795 | Megan Nimke | Pharmacist | 345 Smith Ave North Pharmacy Department, Children's Hospital & Clinics of Minnesota Pharmacy Dep, St. Paul, MN 55102 | 2013-08-19 |
| 1790033363 | Mary Sauer | Pharmacist | 5615 Xerxes Ave N Ste D, Brooklyn Center, MN 55430-2819 | 2012-08-29 |
| Find all providers with the same taxonomy | ||||
| City | OAK PARK HEIGHTS |
| Zip Code | 55082 |
Please comment or provide details below to improve the information on KAYLEE DITTBERNER.
| 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.