Individual provider Active NPI

Craig Michael Leadbetter, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Hillsboro, OR
National Provider Identifier
1093298895
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH-0016587 Issued in OR
Practice address
10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224
Phone
(503) 848-5861
NPI assigned
Sep 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP444738 PA
Pharmacist 183500000X RPH0016587 OR
Pharmacist 183500000X PHA0019379 CO
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0016587 OR Primary

Addresses

Primary practice location

10690 NE Cornell Rd Ste 220
Hillsboro, OR 97124-9224

Mailing address

7320 SW Hunziker Rd Ste 300
Portland, OR 97223-2302
Phone (503) 941-3033

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
PHA0019379COMDPharmacist
RPH0016587ORMDPharmacist
RP444738PAMDPharmacist
RPH-0016587ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1093298895",
    "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": "503-941-3033",
            "fax_number": "503-747-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10690 NE CORNELL RD STE 220",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249224",
            "telephone_number": "503-848-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADBETTER",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-08",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP444738",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH0016587",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "PHA0019379",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0016587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.