Active NPI
Heather Ann Smith
- Pharmacist
- Moscow, ID
National Provider Identifier
1023385523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6403
- Practice address
- 414 N Main St
Moscow, ID 83843-2631 - Phone
- (208) 882-6076
- NPI assigned
- Nov 28, 2011
- Last updated
- Nov 28, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P6403 | ID | Primary |
| Pharmacist | 183500000X | PH60156577 | WA |
Addresses
Primary practice location
414 N Main St
Moscow, ID 83843-2631
Mailing address
2011 11TH Ave
Clarkston, WA 99403-1734
Phone (208) 305-3428
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 |
|---|---|---|---|
| P6403 | ID | MD | Pharmacist |
| PH60156577 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1023385523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2011 11TH AVE",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994031734",
"telephone_number": "208-305-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 N MAIN ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838432631",
"telephone_number": "208-882-6076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "HEATHER",
"middle_name": "ANN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-28",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6403",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60156577",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.