Active NPI
Braden Jeffrey Enfield, RPH
- Pharmacist
- Corvallis, OR
National Provider Identifier
1427604297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0017381
- Practice address
- 2080 NW 9TH St
Corvallis, OR 97330-1484 - Phone
- (541) 753-2226
- Fax
- (541) 753-2559
- NPI assigned
- Aug 16, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0017381 | OR | Primary |
Addresses
Primary practice location
2080 NW 9TH St
Corvallis, OR 97330-1484
Mailing address
2080 NW 9TH St
Corvallis, OR 97330-1484
Phone (541) 753-2226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH-0017381 | Other | OR | STATE RPH LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0017381 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565913600000",
"number": "1427604297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2080 NW 9TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973301484",
"telephone_number": "541-753-2226",
"fax_number": "541-753-2559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 NW 9TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973301484",
"telephone_number": "541-753-2226",
"fax_number": "541-753-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENFIELD",
"first_name": "BRADEN",
"middle_name": "JEFFREY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-16",
"last_updated": "2019-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "0017381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE RPH LICENSE",
"identifier": "RPH-0017381",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.