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
- Last updated
- 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
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 |
Interoperability endpoints
- tina.nguyen@stores.fredmeyer.com
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, 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": "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": [],
"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.