NPIMap

Individual provider Active NPI

Gerald D Gerke

  • Pharmacist
  • Madras, OR
National Provider Identifier
1790021996
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4528 Issued in OR
Practice address
80 NE Cedar St
Madras, OR 97741-1956
Phone
(541) 325-0466
Fax
(541) 325-0468
NPI assigned
Dec 17, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

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
4528ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4528 OR Primary

Addresses

NPPES NPI Registry

Primary practice location

80 NE Cedar St
Madras, OR 97741-1956

Mailing address

80 NE Cedar St
Madras, OR 97741-1956
Phone (541) 325-0466

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2012.

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1790021996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 NE CEDAR ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411956",
            "telephone_number": "541-325-0466",
            "fax_number": "541-325-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NE CEDAR ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411956",
            "telephone_number": "541-325-0466",
            "fax_number": "541-325-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERKE",
        "first_name": "GERALD",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "4528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madras, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.