Active NPI
Tina Nguyen
- Pharmacist
- Medford, OR
National Provider Identifier
1497313100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0017123
- Practice address
- 1301 Center Dr
Medford, OR 97501-7938 - Phone
- (541) 857-4650
- NPI assigned
- May 29, 2019
- Sex
- Female
- 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 | RPH-0017123 | OR | Primary |
Addresses
Primary practice location
1301 Center Dr
Medford, OR 97501-7938
Mailing address
3815 SE 122ND Ave Apt 8
Portland, OR 97236-3759
Phone (503) 473-5292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93-0798201 | Other | INDIVIDUAL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tina.nguyen@stores.fredmeyer.com |
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 |
|---|---|---|---|
| RPH-0017123 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc. | Past | Accepting new patients | |
| Fred Meyer Stores Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Medford, OR
- NPI 1174568562
-
- Community/Retail Pharmacy
- Lynnwood, WA
- NPI 1558235762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1497313100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3815 SE 122ND AVE APT 8",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363759",
"telephone_number": "503-473-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 CENTER DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975017938",
"telephone_number": "541-857-4650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "TINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0017123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL",
"identifier": "93-0798201",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tina.nguyen@stores.fredmeyer.com",
"affiliation": "N",
"address_1": "1301 Center Dr",
"city": "Medford",
"state": "OR",
"country_code": "US",
"postal_code": "975017938",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.