Active NPI
Thomas Endicott, RPH
- Pharmacist
- Klamath Falls, OR
National Provider Identifier
1477854909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6120
- Practice address
- 2740 S 6TH St
Klamath Falls, OR 97603-4604 - Phone
- (541) 273-3515
- Fax
- (541) 273-3518
- NPI assigned
- Nov 15, 2010
- Last updated
- Nov 15, 2010
- 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 | 6120 | OR | Primary |
Addresses
Primary practice location
2740 S 6TH St
Klamath Falls, OR 97603-4604
Mailing address
2740 S 6TH St
Klamath Falls, OR 97603-4604
Phone (541) 273-3515
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 |
|---|---|---|---|
| 6120 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1477854909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2740 S 6TH ST",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976034604",
"telephone_number": "541-273-3515",
"fax_number": "541-273-3518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2740 S 6TH ST",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976034604",
"telephone_number": "541-273-3515",
"fax_number": "541-273-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDICOTT",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "6120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.