Active NPI
Gina Marie Davis, PHARM.D.
- Pharmacist
- Pocatello, ID
National Provider Identifier
1154593754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6084
- Practice address
- 990 Cesar Chavez Ave
Pocatello, ID 83209-0001 - Phone
- (208) 282-3407
- Fax
- (208) 282-6150
- NPI assigned
- Mar 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P6084 | ID | Primary |
Addresses
Primary practice location
990 Cesar Chavez Ave
Pocatello, ID 83209-0001
Mailing address
921 S 8TH Ave Stop 8311
Pocatello, ID 83209-0002
Phone (208) 282-3407
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 |
|---|---|---|---|
| P6084 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho State University | Past | Accepting new patients |
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.
-
- Clinic Pharmacy
- Pocatello, ID
- NPI 1730351081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1154593754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 S 8TH AVE STOP 8311",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832090002",
"telephone_number": "208-282-3407",
"fax_number": "208-282-6150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 CESAR CHAVEZ AVE",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832090001",
"telephone_number": "208-282-3407",
"fax_number": "208-282-6150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "GINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-24",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.