Individual provider Active NPI

Kasey Ann Swanstrom

  • Pharmacist
  • Bend, OR
National Provider Identifier
1164972394
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0015679 Issued in OR
Practice address
60 NE Bend River Mall Dr
Bend, OR 97703-7528
Phone
(541) 385-6076
Fax
(541) 385-9209
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39813 MT
Pharmacist 183500000X 0015679 OR Primary

Addresses

Primary practice location

60 NE Bend River Mall Dr
Bend, OR 97703-7528

Mailing address

60 NE Bend River Mall Dr
Bend, OR 97703-7528
Phone (541) 385-6076

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

State licenses

LicenseStateTypeSpecialty
39813MTMDPharmacist
0015679ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1164972394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 NE BEND RIVER MALL DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037528",
            "telephone_number": "541-385-6076",
            "fax_number": "541-385-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 NE BEND RIVER MALL DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037528",
            "telephone_number": "541-385-6076",
            "fax_number": "541-385-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSTROM",
        "first_name": "KASEY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "39813",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0015679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.