Doug L Kidder, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P4976 Issued in ID

Practice address

520 N 3Rd Ave
Sandpoint, ID 83864-1507

Phone

(208) 305-5196

NPI assigned

Sep 21, 2007

Last updated

Feb 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1063608172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MEADOWLARK LN",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838647526",
            "telephone_number": "208-305-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 3RD AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641507",
            "telephone_number": "208-305-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "DOUG",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4976",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00018504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles E Kees, SLP
• Benjamin Keggi, D.O.
• William Taggart Kent, LCSW
• Adam M Kerr
• Kevin B. Johnson, DDS
• Frazier H King, M.D.
• Jillian Verby Klaucke, MD
• Jonathan Klaucke, M.D.
• Klemz Counseling and Consulting
• Tracey Koch, FNP

• Pharmacist in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.