Active NPI
Erica Zelickowski, PHARMD
- Pharmacist
- Boise, ID
National Provider Identifier
1215364278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6766
- Practice address
- 1653 S Vista Avenue
Boise, ID 83705 - Phone
- (208) 331-3007
- NPI assigned
- Oct 4, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P6766 | ID | Primary |
| Pharmacist | 183500000X | 17649 | NV |
Addresses
Primary practice location
1653 S Vista Avenue
Boise, ID 83705
Mailing address
690 S Clearwater Lane
303
Boise, ID 83712
Phone (208) 968-6019
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P6766 | Other | ID | REGISTERED PHARMACIST |
| 17649 | Other | NV | REGISTERED PHARMACIST |
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 |
|---|---|---|---|
| P6766 | ID | MD | Pharmacist |
| 17649 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1215364278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 S CLEARWATER LANE",
"address_2": "303",
"city": "BOISE",
"state": "ID",
"postal_code": "83712",
"telephone_number": "208-968-6019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1653 S VISTA AVENUE",
"city": "BOISE",
"state": "ID",
"postal_code": "83705",
"telephone_number": "208-331-3007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELICKOWSKI",
"first_name": "ERICA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6766",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "17649",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST",
"identifier": "P6766",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST",
"identifier": "17649",
"state": "NV"
}
],
"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 Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.