NPIMap

Individual provider Active NPI

Michael Orion Tice, PHARMD.

  • Pharmacist
  • Medford, OR
National Provider Identifier
1609278274
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0014225 Issued in OR
Practice address
1301 Center Dr
Medford, OR 97501-7938
Phone
(541) 857-4683
NPI assigned
Sep 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0014225 OR Primary

Addresses

Primary practice location

1301 Center Dr
Medford, OR 97501-7938

Mailing address

1301 Center Dr
Medford, OR 97501-7938

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
RPH-0014225ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1609278274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CENTER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017938"
        },
        {
            "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": "541-857-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "MICHAEL",
        "middle_name": "ORION",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 25, 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.