Individual provider Active NPI

Randye Sue Simcoe, RPH

  • Pharmacist
  • Hailey, ID
National Provider Identifier
1093066433
Registry record updated Sep 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5302 Issued in ID
Practice address
91 E Croy St
Hailey, ID 83333-8407
Phone
(208) 788-9714
NPI assigned
Sep 25, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

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
P5302IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Atkinsons Market, Inc Pharmacist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5302 ID Primary

Addresses

NPPES NPI Registry

Primary practice location

91 E Croy St
Hailey, ID 83333-8407

Mailing address

129 S Hiawatha Dr
Hailey, ID 83333-5053

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2012.

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1093066433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S HIAWATHA DR",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833335053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 E CROY ST",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338407",
            "telephone_number": "208-788-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMCOE",
        "first_name": "RANDYE",
        "middle_name": "SUE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2012; 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.