Individual provider Active NPI

Joseph Abraham IV, PHARMD

  • Pharmacist
  • Coos Bay, OR
National Provider Identifier
1396129565
Registry record updated Jan 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0014680 Issued in OR
Practice address
2051 Newmark Ave
Coos Bay, OR 97420-4728
Phone
(541) 888-5750
Fax
(541) 888-9233
NPI assigned
Jul 16, 2015
Last updated
Jan 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 0014680 OR Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH0014680 OR

Addresses

Primary practice location

2051 Newmark Ave
Coos Bay, OR 97420-4728

Mailing address

2051 Newmark Ave
Coos Bay, OR 97420-4728
Phone (541) 888-5750

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0014680ORMDPharmacist
RPH0014680ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1396129565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 NEWMARK AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204728",
            "telephone_number": "541-888-5750",
            "fax_number": "541-888-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 NEWMARK AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204728",
            "telephone_number": "541-888-5750",
            "fax_number": "541-888-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0014680",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH0014680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.