Individual provider Active NPI

Jodi Lynn Nelson, RPH

  • Pharmacist
  • Eugene, OR
National Provider Identifier
1477826139
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8423 Issued in OR
Practice address
4780 Royal Ave
Eugene, OR 97402-1755
Phone
(541) 463-9559
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8423 OR Primary

Addresses

Primary practice location

4780 Royal Ave
Eugene, OR 97402-1755

Mailing address

1225 Hilo Dr
Eugene, OR 97404-1079
Phone (541) 912-1220

Other practice location 1

2484 River Rd
Eugene, OR 97404-2042
Phone (541) 222-7650

Other identifiers 1

IdentifierTypeStateIssuer
8423OtherORSTATE PHAMACIST 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

LicenseStateTypeSpecialty
8423ORMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1477826139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 HILO DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974041079",
            "telephone_number": "541-912-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 ROYAL AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974021755",
            "telephone_number": "541-463-9559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2484 River Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974042042",
            "country_code": "US",
            "telephone_number": "541-222-7650",
            "fax_number": "541-222-7676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "8423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHAMACIST LICENSE",
            "identifier": "8423",
            "state": "OR"
        }
    ],
    "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 Feb 12, 2025; 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.