Individual provider Active NPI

Jeffrey Alan Schneider, R.PH.

  • Pharmacist
  • Clarkston, WA
National Provider Identifier
1114078540
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P4553 Issued in ID
Practice address
301 5TH St
Clarkston, WA 99403-1860
Phone
(509) 758-8897
NPI assigned
Jan 13, 2007
Last updated
Sep 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P4553 ID Primary
Pharmacist 183500000X PH00011839 WA
Pharmacist 183500000X 2732 MT

Addresses

Primary practice location

301 5TH St
Clarkston, WA 99403-1860

Mailing address

1907 Powers Dr
Lewiston, ID 83501-6042
Phone (208) 746-7237

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
P4553IDMDPharmacist
2732MTMDPharmacist
PH00011839WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1114078540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 POWERS DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835016042",
            "telephone_number": "208-746-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 5TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031860",
            "telephone_number": "509-758-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4553",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00011839",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "2732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.