Active NPI
Cody R Beaumont, PHARMD
- Pharmacist
- Klamath Falls, OR
National Provider Identifier
1235151184
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Mar 19, 2009.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH0010764
- Practice address
- 2865 Daggett Ave
Merle West Medical Center
Klamath Falls, OR 97601 - Phone
- (541) 883-6263
- Fax
- (541) 883-6216
- NPI assigned
- Jul 23, 2006
- 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 | RPH0010764 | OR | Primary |
| Pharmacist | 183500000X | 3604171701 | UT |
Addresses
Primary practice location
2865 Daggett Ave
Merle West Medical Center
Klamath Falls, OR 97601
Mailing address
4261 Gary St
Klamath Falls, OR 97603
Phone (541) 273-2839
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH0010764 | OR | MD | Pharmacist |
| 3604171701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235151184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4261 GARY ST",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "97603",
"telephone_number": "541-273-2839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 DAGGETT AVE",
"address_2": "MERLE WEST MEDICAL CENTER",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "97601",
"telephone_number": "541-883-6263",
"fax_number": "541-883-6216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUMONT",
"first_name": "CODY",
"middle_name": "R",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH0010764",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "3604171701",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.