Individual provider Active NPI

Frederick Jon Harman, RPH

  • Pharmacist
  • Salem, OR
National Provider Identifier
1104199322
Registry record updated Feb 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8694 Issued in OR
Practice address
2155 Lancaster Dr NE
Salem, OR 97305-1228
Phone
(503) 588-8173
NPI assigned
Feb 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8694 OR Primary

Addresses

Primary practice location

2155 Lancaster Dr NE
Salem, OR 97305-1228

Mailing address

6121 Santiam Springs CT SE
Salem, OR 97317-9544
Phone (503) 508-2468

Other identifiers 1

IdentifierTypeStateIssuer
8694OtherORSTATE PHARMACIST LICENSE

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8694ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1329523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329523200000",
    "number": "1104199322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 SANTIAM SPRINGS CT SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179544",
            "telephone_number": "503-508-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051228",
            "telephone_number": "503-588-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMAN",
        "first_name": "FREDERICK",
        "middle_name": "JON",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-18",
        "last_updated": "2012-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "8694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "8694",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2012; 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.