Active NPI
Dean Lucas Carson, RPH
- Pharmacist
- Salem, OR
National Provider Identifier
1114369287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0013170
- Practice address
- 3740 Market St NE
Salem, OR 97301-1826 - Phone
- (503) 370-4351
- Fax
- (503) 370-4892
- NPI assigned
- Jul 18, 2013
- Last updated
- May 9, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0013170 | OR | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0013170 | OR |
Addresses
Primary practice location
3740 Market St NE
Salem, OR 97301-1826
Mailing address
7555 SW Barbur Blvd
Portland, OR 97219-3090
Phone (503) 452-3033
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0013170 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc | Past | Accepting new patients | |
| Fred Meyer Stores Inc. | Past | Accepting new patients | |
| Fred Meyer Stores Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1114369287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7555 SW BARBUR BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972193090",
"telephone_number": "503-452-3033",
"fax_number": "503-452-3027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3740 MARKET ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011826",
"telephone_number": "503-370-4351",
"fax_number": "503-370-4892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON",
"first_name": "DEAN",
"middle_name": "LUCAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-18",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0013170",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "0013170",
"primary": false
}
],
"identifiers": [],
"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 May 9, 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.