Individual provider Active NPI

Karen D Lodge, RPH

  • Pharmacist
  • Boise, ID
National Provider Identifier
1134483845
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5386 Issued in ID
Practice address
5211 S Farmhouse PL
Boise, ID 83716
Phone
(208) 724-9338
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5386 ID Primary

Addresses

Primary practice location

5211 S Farmhouse PL
Boise, ID 83716

Mailing address

5211 S Farmhouse PL
Boise, ID 83716-9014
Phone (208) 724-9338

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
P5386IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1134483845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 S FARMHOUSE PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837169014",
            "telephone_number": "208-724-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 S FARMHOUSE PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83716",
            "telephone_number": "208-724-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "KAREN",
        "middle_name": "D",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.