Individual provider Active NPI

Aaron M Ballensky

  • Pharmacist
  • Roseburg, OR
National Provider Identifier
1629320486
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PI-0010645 Issued in OR
Practice address
390 N River Dr
Roseburg, OR 97470-8008
Phone
(541) 743-5445
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PI-0010645 OR Primary

Addresses

Primary practice location

390 N River Dr
Roseburg, OR 97470-8008

Mailing address

390 N River Dr
Roseburg, OR 97470-8008

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

LicenseStateTypeSpecialty
PI-0010645ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1629320486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N RIVER DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974708008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N RIVER DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974708008",
            "telephone_number": "541-743-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENSKY",
        "first_name": "AARON",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "PI-0010645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.