Individual provider Active NPI

Sarah Ross Balben, RPH

  • Pharmacist
  • Tetonia, ID
National Provider Identifier
1083937114
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2242 Issued in WY
Practice address
1080 W 8750 N
Tetonia, ID 83452-4877
Phone
(307) 733-9768
Fax
(307) 733-3528
NPI assigned
Mar 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2242 WY Primary

Addresses

Primary practice location

1080 W 8750 N
Tetonia, ID 83452-4877

Mailing address

1080 W 8750 N
Tetonia, ID 83452-4877
Phone (307) 733-9768

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
2242WYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1083937114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 W 8750 N",
            "city": "TETONIA",
            "state": "ID",
            "postal_code": "834524877",
            "telephone_number": "307-733-9768",
            "fax_number": "307-733-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 W 8750 N",
            "city": "TETONIA",
            "state": "ID",
            "postal_code": "834524877",
            "telephone_number": "307-733-9768",
            "fax_number": "307-733-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBEN",
        "first_name": "SARAH",
        "middle_name": "ROSS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "2242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tetonia, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.