Royce G Peterson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0012258 Issued in OR

Practice address

700 Campbell St
Baker City, OR 97814-2212

Phone

(541) 523-0607

Fax

(541) 523-0589

NPI assigned

Feb 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1598038317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CAMPBELL ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978142212",
            "telephone_number": "541-523-0607",
            "fax_number": "541-523-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CAMPBELL ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978142212",
            "telephone_number": "541-523-0607",
            "fax_number": "541-523-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROYCE",
        "middle_name": "G",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0012258",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "0012258",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "P6405",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norman Pelley
• Alissa A Percival, OTR/L
• Curtis Allen Peters, DMD
• Amanda Ruth Petersen, MSW
• Mandy M Peterson, RD
• Marla Vivian Petrik
• Jon Eric Petterson, M.D.
• Jeana L. Phillips, LPC
• Matthew A Pickering, RPH
• Pin and Tonics

• Pharmacist in Baker City, OR
• Providers in Baker City, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.