Active NPI
Adam Leslie Anderson, PHARMD, RPH
- Pharmacist
- La Pine, OR
National Provider Identifier
1841556263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0012679
- Practice address
- 51670 Huntington Rd
La Pine, OR 97739-9626 - Phone
- (541) 536-5052
- Fax
- (541) 536-1488
- NPI assigned
- Apr 10, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0012679 | OR | Primary |
Addresses
Primary practice location
51670 Huntington Rd
La Pine, OR 97739-9626
Mailing address
51670 Huntington Rd
PO Box 1976
La Pine, OR 97739-9626
Phone (541) 536-5052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH-0012679 | Other | OR | STATE PHARMACIST 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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0012679 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1841556263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51670 HUNTINGTON RD",
"address_2": "PO BOX 1976",
"city": "LA PINE",
"state": "OR",
"postal_code": "977399626",
"telephone_number": "541-536-5052",
"fax_number": "541-536-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51670 HUNTINGTON RD",
"city": "LA PINE",
"state": "OR",
"postal_code": "977399626",
"telephone_number": "541-536-5052",
"fax_number": "541-536-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ADAM",
"middle_name": "LESLIE",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-10",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0012679",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE",
"identifier": "RPH-0012679",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Pine, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.