Individual provider Active NPI

Tim Keffeler, PHARM.D.

  • Pharmacist
  • Ukiah, CA
National Provider Identifier
1992396501
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
58540 Issued in CA
Practice address
260 Hospital Dr Ste 111
Ukiah, CA 95482-4568
Phone
(707) 468-1866
Fax
(707) 468-1869
NPI assigned
Jan 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 58540 CA Primary

Addresses

Primary practice location

260 Hospital Dr Ste 111
Ukiah, CA 95482-4568

Mailing address

260 Hospital Dr Ste 111
Ukiah, CA 95482-4568
Phone (707) 468-1866

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
58540CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Keffeler Pharmaceutical Inc CurrentSince Jan 31, 2021 Accepting new patients
Thomas D Reidenbach PastSince Jan 31, 2021 Accepting new patients

Locations

260 Hospital Dr
Ste 111
Ukiah, CA 95482
Phone (707) 468-1866

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.

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1992396501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 111",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-468-1866",
            "fax_number": "707-468-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 111",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-468-1866",
            "fax_number": "707-468-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFFELER",
        "first_name": "TIM",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.