Kristy Lynn Fordyce, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

P5254 Issued in ID

Practice address

800 Yellowstone Ave
Pocatello, ID 83201-4433

Phone

(208) 239-4033

Fax

(208) 239-4027

NPI assigned

Apr 25, 2008

Last updated

Jan 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Fred Meyer Stores Inc

  dba Fred Meyer Pharmacy

  • Community/Retail Pharmacy
  • Pocatello, ID
  • NPI 1740225275
  NPD (past)
• Fred Meyer Stores Inc.

  dba QFC Pharmacy #835

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1144495615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 YELLOWSTONE AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014433",
            "telephone_number": "208-239-4033",
            "fax_number": "208-239-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 YELLOWSTONE AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014433",
            "telephone_number": "208-239-4033",
            "fax_number": "208-239-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDYCE",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5254",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "ID",
            "license": "P5254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanelle Renee Foltz
• Gwendoline Fonebi, M.D.
• Jade Forbush, RDMS
• Rex W Force, PHARMD
• Gregory M Ford, MD
• John M Fornarotto, M.D.
• Tanya R Forsman, MC
• Foster Investments LLC
• Jacob R Foster, PA-C
• Madeline Claire Foster, PHARMD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.