Individual provider Active NPI

Kenneth S McCloud, RPH

  • Pharmacist
  • Eugene, OR
National Provider Identifier
1467889709
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8274 Issued in OR
Practice address
1675 W 18TH Ave
Eugene, OR 97402-3814
Phone
(541) 485-0427
Fax
(541) 485-1484
NPI assigned
Oct 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 8274 OR Primary

Addresses

Primary practice location

1675 W 18TH Ave
Eugene, OR 97402-3814

Mailing address

1828 Calistoga CT
Eugene, OR 97402-7527
Phone (541) 485-0427

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
8274ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1467889709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 CALISTOGA CT",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974027527",
            "telephone_number": "541-485-0427",
            "fax_number": "541-485-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023814",
            "telephone_number": "541-485-0427",
            "fax_number": "541-485-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOUD",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "8274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.