Individual provider Active NPI

Trevor Laursen, PHARMD

  • Ambulatory Care Pharmacist
  • Medford, OR
National Provider Identifier
1780109090
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
0016737 Issued in OR
Practice address
3225 Hillcrest Park Dr
Medford, OR 97504-7657
Phone
(541) 774-5700
NPI assigned
Aug 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8689261-1701 UT
Ambulatory Care Pharmacist 1835P2201X 0016737 OR Primary

Addresses

Primary practice location

3225 Hillcrest Park Dr
Medford, OR 97504-7657

Mailing address

3225 Hillcrest Park Dr
Medford, OR 97504-7657
Phone (503) 893-6900

Other practice location 1

1698 E McAndrews Rd Ste 300
Medford, OR 97504-5590
Phone (541) 734-5068

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
8689261-1701UTMDPharmacist
0016737ORMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1780109090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 HILLCREST PARK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047657",
            "telephone_number": "503-893-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 HILLCREST PARK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047657",
            "telephone_number": "541-774-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1698 E McAndrews Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975045590",
            "country_code": "US",
            "telephone_number": "541-734-5068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "8689261-1701",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "0016737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.