Jovin V Panthapattu, PHARM.D. BCACP

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

RPH-0016544 Issued in OR

Practice address

178 SW 2ND Ave
Canby, OR 97013-4152

Phone

(503) 416-4547

Fax

(503) 416-4553

NPI assigned

Feb 4, 2015

Last updated

Apr 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1073903563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "035-941-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 SW 2ND AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970134152",
            "telephone_number": "503-416-4547",
            "fax_number": "503-416-4553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 Molalla Ave",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970452799",
            "country_code": "US",
            "telephone_number": "503-656-9030",
            "fax_number": "503-656-9026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTHAPATTU",
        "first_name": "JOVIN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "PHARM.D. BCACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "RPH-0016544",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0016544-P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500758246",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Orelski, PA-C
• Kayla Ormsby
• Lily Frances Packer
• Unique Layshaun Page, LPC
• Emily Ann Palmer, MA, LPCI
• Jooae Park, D.C
• Sehoon Park
• Leah Parsley, L.M.T.
• Kyle Passey, DPT
• Patrick J Gregg MD PC

• Ambulatory Care Pharmacist in Canby, OR
• Providers in Canby, OR by specialty
• Ambulatory Care Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.