Individual provider Active NPI

Gerald Dana Radant, RPH

  • Pharmacist
  • Bend, OR
National Provider Identifier
1275967382
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
06369 Issued in OR
Practice address
60 NE Bend River Mall Dr
Bend, OR 97701-7528
Phone
(541) 385-6076
NPI assigned
Aug 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 06369 OR Primary

Addresses

Primary practice location

60 NE Bend River Mall Dr
Bend, OR 97701-7528

Mailing address

20818 Solstice Dr
Bend, OR 97701-8404
Phone (541) 408-4858

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
06369ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1275967382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20818 SOLSTICE DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018404",
            "telephone_number": "541-408-4858"
        },
        {
            "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": "977017528",
            "telephone_number": "541-385-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADANT",
        "first_name": "GERALD",
        "middle_name": "DANA",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "06369",
            "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 Aug 26, 2013; 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.