Active NPI
Kendall A Membreno
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Klamath Falls, OR
National Provider Identifier
1902073992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH0016207
- Practice address
- 2655 Shasta Way
Klamath Falls, OR 97603 - Phone
- (541) 884-1780
- NPI assigned
- May 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 57199 | CA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH0016207 | OR | Primary |
Addresses
Primary practice location
2655 Shasta Way
Klamath Falls, OR 97603
Mailing address
822 Corte Baya Vis
Oxnard, CA 93030-8054
Phone (626) 202-3610
Other practice location 1
35 S Milpas St
Santa Barbara, CA 93103-3305
Phone (805) 965-0787
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
| License | State | Type | Specialty |
|---|---|---|---|
| 57199 | CA | MD | Dentist |
| RPH0016207 | OR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Santa Barbara, CA
- NPI 1114036563
-
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531872000000",
"number": "1902073992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 CORTE BAYA VIS",
"city": "OXNARD",
"state": "CA",
"postal_code": "930308054",
"telephone_number": "626-202-3610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2655 SHASTA WAY",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "97603",
"telephone_number": "541-884-1780"
}
],
"practiceLocations": [
{
"address_1": "35 S Milpas St",
"address_purpose": "LOCATION",
"city": "Santa Barbara",
"state": "CA",
"postal_code": "931033305",
"country_code": "US",
"telephone_number": "805-965-0787",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEMBRENO",
"first_name": "KENDALL",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-09",
"last_updated": "2018-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57199",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "RPH0016207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.