Individual provider Active NPI

Vickieann Rosenbusch Poremba, PHARMD

  • Ambulatory Care Pharmacist
  • Medford, OR
National Provider Identifier
1063847796
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
RPH-0014310 Issued in OR
Practice address
1698 E McAndrews Rd Ste 300
Medford, OR 97504-5590
Phone
(541) 732-7950
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60371567 WA
Ambulatory Care Pharmacist 1835P2201X RPH-0014310 OR Primary
Pharmacist 183500000X 5302038967 MI

Addresses

Primary practice location

1698 E McAndrews Rd Ste 300
Medford, OR 97504-5590

Mailing address

1698 E McAndrews Rd Ste 300
Medford, OR 97504-5590
Phone (541) 732-7950

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
5302038967MIMDPharmacist
PH60371567WAMDPharmacist
RPH-0014310ORMDAmbulatory Care Pharmacist

Interoperability endpoints

  • Direct secure messaging: vporemba4120149@ghc.direct-ci.net

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1063847796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045590",
            "telephone_number": "541-732-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045590",
            "telephone_number": "541-732-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POREMBA",
        "first_name": "VICKIEANN",
        "middle_name": "ROSENBUSCH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60371567",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "RPH-0014310",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302038967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.