Individual provider Active NPI

Jeff Chudek, PHARM.D.

  • Pharmacist
  • Wilsonville, OR
National Provider Identifier
1821375692
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0012737 Issued in OR
Practice address
25925 SW Heather PL
T-1847
Wilsonville, OR 97070-5785
Phone
(503) 682-7793
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0012737 OR Primary

Addresses

Primary practice location

25925 SW Heather PL
T-1847
Wilsonville, OR 97070-5785

Mailing address

25925 SW Heather PL
T-1847
Wilsonville, OR 97070-5785
Phone (503) 682-7793

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
0012737ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1821375692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25925 SW HEATHER PL",
            "address_2": "T-1847",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705785",
            "telephone_number": "503-682-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25925 SW HEATHER PL",
            "address_2": "T-1847",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970705785",
            "telephone_number": "503-682-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDEK",
        "first_name": "JEFF",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0012737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.