Individual provider Active NPI

Jennifer Campbell, RPH

  • Pharmacist
  • Meridian, ID
National Provider Identifier
1013553007
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P8457 Issued in ID
Practice address
1570 E Fairview Ave
Meridian, ID 83642-1821
Phone
(208) 888-0034
Fax
(208) 887-1332
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P8457 ID Primary

Addresses

Primary practice location

1570 E Fairview Ave
Meridian, ID 83642-1821

Mailing address

575 W Elias St
Meridian, ID 83642-8127
Phone (435) 680-1169

Other practice location 1

575 W Elias St
Meridian, ID 83642-8127
Phone (435) 680-1169

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

LicenseStateTypeSpecialty
P8457IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Dec 1, 2019 Accepting new patients
Walgreen Co PastSince Dec 1, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1013553007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W ELIAS ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428127",
            "telephone_number": "435-680-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 E FAIRVIEW AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421821",
            "telephone_number": "208-888-0034",
            "fax_number": "208-887-1332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 W Elias St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428127",
            "country_code": "US",
            "telephone_number": "435-680-1169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNIFER",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P8457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.