Individual provider Active NPI

Erin Michelle Vodka

  • Pharmacist
  • Salem, OR
National Provider Identifier
1689050775
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0014795 Issued in OR
Practice address
2150 Fairgrounds Rd NE
Salem, OR 97301-0641
Phone
(503) 428-5107
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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-0014795 OR Primary

Addresses

Primary practice location

2150 Fairgrounds Rd NE
Salem, OR 97301-0641

Mailing address

2150 Fairgrounds Rd NE
Salem, OR 97301-0641
Phone (503) 428-5107

Other practice location 1

5000 River Rd N
Keizer, OR 97303-5325
Phone (503) 390-2642

Other names 1

  • Erin Michelle Johnson Former name

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
RPH-0014795ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Locations

2150 Fairgrounds Rd NE
Salem, OR 97301
Phone (503) 428-5107

Interoperability endpoints

  • Direct secure messaging: erin.vodka.p96@direct.wvp.nextgenshare.com

Organizations & group practices 3

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": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1689050775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 FAIRGROUNDS RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010641",
            "telephone_number": "503-428-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 FAIRGROUNDS RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010641",
            "telephone_number": "503-428-5107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 River Rd N",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973035325",
            "country_code": "US",
            "telephone_number": "503-390-2642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VODKA",
        "first_name": "ERIN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "JOHNSON",
            "middle_name": "MICHELLE",
            "credential": "PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.