Active NPI
Coleman Gayheart Jr., PHARMACIST
- Ambulatory Care Pharmacist
- Terrebonne, OR
National Provider Identifier
1457881468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 8739
- Practice address
- 12981 SW Upper Ridge Rd
Terrebonne, OR 97760-9212 - Phone
- (541) 306-0655
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 8739 | OR | Primary |
Addresses
Primary practice location
12981 SW Upper Ridge Rd
Terrebonne, OR 97760-9212
Mailing address
12981 SW Upper Ridge Rd
Terrebonne, OR 97760-9212
Phone (541) 306-0655
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8739 | OR | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1457881468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12981 SW UPPER RIDGE RD",
"city": "TERREBONNE",
"state": "OR",
"postal_code": "977609212",
"telephone_number": "541-306-0655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12981 SW UPPER RIDGE RD",
"city": "TERREBONNE",
"state": "OR",
"postal_code": "977609212",
"telephone_number": "541-306-0655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYHEART",
"first_name": "COLEMAN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "OR",
"license": "8739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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- Kim Rochelle Kirk, RN
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- Cynthia McDaniel, RN MSN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.