DR. BRAXTON TRISTAN MICHAEL MEHL (NPI# 1427336577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427336577 |
| Entity Type | Individual |
| Full Name | DR. BRAXTON TRISTAN MICHAEL MEHL |
| Credential | PHARMD |
| Practice Address |
2000 Crater Lake Hwy T-0613 Medford OR 97504-4161 |
| Practice Telephone | 5417795110 |
| Mailing Telephone | 5417795110 |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0012677 | OR | Pharmacy Service Providers |
| Street Address |
2000 CRATER LAKE HWY T-0613 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-4161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568484285 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2006-07-24 |
| 1154955359 | Brandon Berioso | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2020-02-26 |
| 1972916492 | Loren Podoll | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2014-06-03 |
| 1891121596 | Brittany Brooks Lapham | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2013-09-25 |
| 1003103631 | Mark K Williams | Pharmacist | 2000 Crater Lake Hwy, T-00613, Medford, OR 97504-4161 | 2011-07-04 |
| 1124315973 | Rudolf Dickeinstein Tanga | Pharmacist | 2000 Crater Lake Hwy, T0613, Medford, OR 97504-4161 | 2011-06-30 |
| 1962796144 | Sharon Dillingham | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2011-06-05 |
| 1982721833 | Michael D. Gilbert | Pharmacist | 2000 Crater Lake Hwy, Medford, OR 97504-4161 | 2007-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245934 | Stephen Choi | Pharmacist | 12 Blakely Rd, Medford, MA 02155-2409 | 2020-11-02 |
| 1366084592 | Michael Kasik | Pharmacist | 701 Black Oak Dr, Medford, OR 97504-8550 | 2019-10-09 |
| 1316594898 | Christ Ange G Katche | Pharmacist | 21 College Ave Apt 1, Medford, MA 02155-4571 | 2019-08-20 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1770059537 | Kamal Kotaich | Pharmacist | 140 S Holly St Ste 1131, Medford, OR 97501-3113 | 2018-10-19 |
| 1851778211 | Kyle Mason | Pharmacist | 34 Tallowood Dr, Medford, NJ 08055-9147 | 2015-05-05 |
| 1174931331 | Justina Sokolovas | Pharmacist | 1350 Center Drive, Pharmacy Department, Medford, OR 97501 | 2014-07-31 |
| 1295152759 | Marvin Wainwright | Pharmacist | 5 Wilkins Station Rd, Suite 100, Medford, NJ 08055-9606 | 2014-03-23 |
| 1780008466 | Catherine Rimov | Pharmacist | 4449 Vista Pointe Dr, Medford, OR 97504-8084 | 2014-02-14 |
| 1992141584 | Jerry C Hood | Pharmacist | 2425 Nieto Way, Medford, OR 97504-8577 | 2013-05-22 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.