Active NPI
Heidi Doreen Eliason, RPH
- Pharmacist
- Hailey, ID
National Provider Identifier
1013283274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P4623
- Practice address
- 91 E Croy St
Hailey, ID 83333-8407 - Phone
- (208) 788-9714
- Fax
- (208) 799-2966
- NPI assigned
- Mar 31, 2012
- Sex
- Female
- 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 | P4623 | ID | Primary |
Addresses
Primary practice location
91 E Croy St
Hailey, ID 83333-8407
Mailing address
PO Box 2700
Hailey, ID 83333-2700
Phone (208) 788-9714
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4623 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atkinsons Market, Inc | Pharmacist | Current | Accepting new patients |
Locations
91 E Croy St
Hailey, ID 83333
Phone (208) 788-9714
Organizations & group practices 1
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": "1333152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333152000000",
"number": "1013283274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2700",
"city": "HAILEY",
"state": "ID",
"postal_code": "833332700",
"telephone_number": "208-788-9714",
"fax_number": "208-788-2966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 E CROY ST",
"city": "HAILEY",
"state": "ID",
"postal_code": "833338407",
"telephone_number": "208-788-9714",
"fax_number": "208-799-2966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIASON",
"first_name": "HEIDI",
"middle_name": "DOREEN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-31",
"last_updated": "2012-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P4623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hailey, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.