Individual provider Active NPI

Paul Kirse, RPH

  • Pharmacist
  • Hermiston, OR
National Provider Identifier
1639710197
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0017523 Issued in OR
Practice address
990 S Highway 395
Hermiston, OR 97838-2623
Phone
(541) 564-1285
Fax
(541) 564-1288
NPI assigned
Oct 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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-0017523 OR Primary

Addresses

Primary practice location

990 S Highway 395
Hermiston, OR 97838-2623

Mailing address

261 SW 28TH Dr
Pendleton, OR 97801-1886
Phone (503) 332-8661

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH-0017523ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc PastSince Oct 6, 2019 Accepting new patients
Safeway Inc PastSince Oct 6, 2019 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": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1639710197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 SW 28TH DR",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978011886",
            "telephone_number": "503-332-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 S HIGHWAY 395",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382623",
            "telephone_number": "541-564-1285",
            "fax_number": "541-564-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSE",
        "first_name": "PAUL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0017523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.