Individual provider Active NPI

Tara Lynn Okeeffe, RPH

  • Pharmacist
  • Bend, OR
National Provider Identifier
1720347198
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6582 Issued in OR
Practice address
210 SW Century Dr
Bend, OR 97702-1958
Phone
(541) 389-9117
NPI assigned
May 4, 2012
Last updated
May 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 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 6582 OR Primary

Addresses

Primary practice location

210 SW Century Dr
Bend, OR 97702-1958

Mailing address

19637 Sunshine Way
Bend, OR 97702-1981
Phone (541) 241-0021

Other identifiers 1

IdentifierTypeStateIssuer
6582OtherORSTATE PHARMACISTS LICENSE

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
6582ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1720347198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19637 SUNSHINE WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021981",
            "telephone_number": "541-241-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SW CENTURY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021958",
            "telephone_number": "541-389-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEEFFE",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "6582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACISTS LICENSE",
            "identifier": "6582",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

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