Individual provider Active NPI

Carlie M Soper, PHARM.D.

  • Pharmacist
  • Eagle Butte, SD
National Provider Identifier
1194101105
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6279 Issued in SD
Practice address
24276 166TH Street Airport Road
Eagle Butte, SD 57625
Phone
(605) 964-7724
Fax
(605) 964-1340
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6279 SD Primary

Addresses

Primary practice location

24276 166TH Street Airport Road
Eagle Butte, SD 57625

Mailing address

PO Box 1012
Eagle Butte, SD 57625-1012
Phone (605) 964-7724

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

LicenseStateTypeSpecialty
6279SDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1194101105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1012",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251012",
            "telephone_number": "605-964-7724",
            "fax_number": "605-964-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 166TH STREET AIRPORT ROAD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-7724",
            "fax_number": "605-964-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPER",
        "first_name": "CARLIE",
        "middle_name": "M",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "6279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Butte, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.