Active NPI
Bradley Thiren Johnson, RPH,CGP,CDM
- Pharmacist
- Eugene, OR
National Provider Identifier
1710984588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6258
- Practice address
- 4010 Aerial Way
Eugene, OR 97402-9757 - Phone
- (541) 242-8525
- Fax
- (541) 242-8520
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6258 | OR | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | HD032131 | OR |
Addresses
Primary practice location
4010 Aerial Way
Eugene, OR 97402-9757
Mailing address
1125 Lorella Ave
Eugene, OR 97401-7823
Phone (541) 343-7162
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0759 | Other | OR | GERIATRIC CERTIFICATION |
| 6258 | Other | OR | PHARMACY LISCENSE |
| HD032131 | Other | OR | DIABETES MANAGMENT CERTIF |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6258 | OR | MD | Chiropractor |
| HD032131 | OR | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1710984588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 LORELLA AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974017823",
"telephone_number": "541-343-7162",
"fax_number": "541-242-8303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 AERIAL WAY",
"city": "EUGENE",
"state": "OR",
"postal_code": "974029757",
"telephone_number": "541-242-8525",
"fax_number": "541-242-8520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRADLEY",
"middle_name": "THIREN",
"name_prefix": "Mr.",
"credential": "RPH,CGP,CDM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "6258",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "OR",
"license": "HD032131",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GERIATRIC CERTIFICATION",
"identifier": "0759",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LISCENSE",
"identifier": "6258",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIABETES MANAGMENT CERTIF",
"identifier": "HD032131",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.