Individual provider Active NPI

Sheryl Blodgett, PHARMD

  • Pharmacist
  • Beaverton, OR
National Provider Identifier
1588074520
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10500 Issued in OR
Practice address
9775 SW Gemini Dr
Suite 1
Beaverton, OR 97008-7148
Phone
(866) 202-4014
Fax
(866) 877-2370
NPI assigned
Apr 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10500 OR Primary
Pharmacist 183500000X 33325 TN
Pharmacist 183500000X 10532 NV
Pharmacist 183500000X 43465 CA

Addresses

Primary practice location

9775 SW Gemini Dr
Suite 1
Beaverton, OR 97008-7148

Mailing address

9775 SW Gemini Dr
Suite 1
Beaverton, OR 97008-7148
Phone (866) 202-4014

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
43465CAMDMarriage & Family Therapist
10500ORMDPharmacist
33325TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1588074520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9775 SW GEMINI DR",
            "address_2": "SUITE 1",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087148",
            "telephone_number": "866-202-4014",
            "fax_number": "866-877-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9775 SW GEMINI DR",
            "address_2": "SUITE 1",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087148",
            "telephone_number": "866-202-4014",
            "fax_number": "866-877-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "SHERYL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "10500",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "33325",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "10532",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.