Active NPI
Todd J Lundquist, PHARMD
- Pharmacist
- Rexburg, ID
National Provider Identifier
1093224842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4003
- Practice address
- 1450 N 2ND E
Rexburg, ID 83440-5131 - Phone
- (208) 359-2814
- Fax
- (208) 359-2816
- NPI assigned
- Sep 25, 2017
- Last updated
- Jun 5, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P7820 | ID | |
| Pharmacist | 183500000X | 4003 | WY | Primary |
Addresses
Primary practice location
1450 N 2ND E
Rexburg, ID 83440-5131
Mailing address
1450 N 2ND E
Rexburg, ID 83440-5131
Phone (208) 359-2814
Other practice location 1
2390 E Cedar St
Rawlins, WY 82301-6026
Phone (307) 417-3058
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P7820 | ID | MD | Pharmacist |
| 4003 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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": "1506297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654387200000",
"number": "1093224842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 N 2ND E",
"city": "REXBURG",
"state": "ID",
"postal_code": "834405131",
"telephone_number": "208-359-2814",
"fax_number": "208-359-2816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 N 2ND E",
"city": "REXBURG",
"state": "ID",
"postal_code": "834405131",
"telephone_number": "208-359-2814",
"fax_number": "208-359-2816"
}
],
"practiceLocations": [
{
"address_1": "2390 E Cedar St",
"address_purpose": "LOCATION",
"city": "Rawlins",
"state": "WY",
"postal_code": "823016026",
"country_code": "US",
"telephone_number": "307-417-3058",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUNDQUIST",
"first_name": "TODD",
"middle_name": "J",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-25",
"last_updated": "2022-06-05",
"certification_date": "2022-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P7820",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "4003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.