Active NPI
Jeff Rundberg
- Pharmacist
- North Bend, OR
National Provider Identifier
1710250501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0010505
- Practice address
- 2131 Newmark St
North Bend, OR 97459-1219 - Phone
- (541) 756-7561
- NPI assigned
- Feb 9, 2012
- Last updated
- Feb 9, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0010505 | OR | Primary |
Addresses
Primary practice location
2131 Newmark St
North Bend, OR 97459-1219
Mailing address
2131 Newmark St
North Bend, OR 97459-1219
Phone (541) 756-7561
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0010505 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1710250501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2131 NEWMARK ST",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974591219",
"telephone_number": "541-756-7561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 NEWMARK ST",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974591219",
"telephone_number": "541-756-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNDBERG",
"first_name": "JEFF",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-09",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0010505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.