Active NPI
James D Nelson, RPH
- Pharmacist
- Caldwell, ID
National Provider Identifier
1033377189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2636
- Practice address
- 4110 S 10TH Ave
Caldwell, ID 83605-5706 - Phone
- (208) 402-0154
- NPI assigned
- May 27, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0008891 | OR | |
| Pharmacist | 183500000X | P5012 | ID | |
| Pharmacist | 183500000X | 2636 | MT | Primary |
Addresses
Primary practice location
4110 S 10TH Ave
Caldwell, ID 83605-5706
Mailing address
4110 S 10TH Ave
Caldwell, ID 83605-5706
Phone (208) 402-0154
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 |
|---|---|---|---|
| 2636 | MT | MD | Addiction (Substance Use Disorder) Counselor |
| P5012 | ID | MD | Pharmacist |
| RPH-0008891 | OR | 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 and National Provider Directory roles.
-
- Pharmacy
- Caldwell, ID
- NPI 1902087794
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250467200000",
"number": "1033377189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 S 10TH AVE",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836055706",
"telephone_number": "208-402-0154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 S 10TH AVE",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836055706",
"telephone_number": "208-402-0154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JAMES",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2009-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0008891",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P5012",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "2636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.