Individual provider Active NPI

Nicole Natasia Gupta, PHARM D.

  • Pharmacist
  • Tigard, OR
National Provider Identifier
1427280536
Registry record updated Aug 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0011808 Issued in OR
Practice address
12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354
Phone
(503) 590-7346
NPI assigned
Aug 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0011808 OR Primary

Addresses

Primary practice location

12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354

Mailing address

12240 SW Scholls Ferry Rd
Tigard, OR 97223-3354
Phone (503) 590-7346

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
RPH-0011808ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1250985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250985600000",
    "number": "1427280536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12240 SW SCHOLLS FERRY RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233354",
            "telephone_number": "503-590-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12240 SW SCHOLLS FERRY RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233354",
            "telephone_number": "503-590-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NICOLE",
        "middle_name": "NATASIA",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-23",
        "last_updated": "2009-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0011808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2009; 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.