Individual provider Active NPI

Jeff Thomas Gerhardson, PHARM-D

  • Pharmacist
  • Redding, CA
National Provider Identifier
1043762784
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
40179 Issued in CA
Practice address
4531 Shannon PL
Redding, CA 96001-6010
Phone
(530) 244-8600
Fax
(530) 244-8605
NPI assigned
Oct 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 40179 CA Primary

Addresses

Primary practice location

4531 Shannon PL
Redding, CA 96001-6010

Mailing address

4531 Shannon PL
Redding, CA 96001-6010
Phone (530) 244-8600

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

LicenseStateTypeSpecialty
40179CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1043762784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SHANNON PL",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960016010",
            "telephone_number": "530-244-8600",
            "fax_number": "530-244-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SHANNON PL",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960016010",
            "telephone_number": "530-244-8600",
            "fax_number": "530-244-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERHARDSON",
        "first_name": "JEFF",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARM-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "40179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.