Active NPI
Bodell H Maughan, PHARMD
- Pharmacist
- Idaho Falls, ID
National Provider Identifier
1255240081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P5508
- Practice address
- 5303 Tildy LN
Idaho Falls, ID 83401-6038 - Phone
- (208) 406-1620
- NPI assigned
- Sep 7, 2026
- Sex
- Male
- 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 | P5508 | ID | Primary |
Addresses
Primary practice location
5303 Tildy LN
Idaho Falls, ID 83401-6038
Mailing address
5303 Tildy LN
Idaho Falls, ID 83401-6038
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1255240081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5303 TILDY LN",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834016038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5303 TILDY LN",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834016038",
"telephone_number": "208-406-1620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUGHAN",
"first_name": "BODELL",
"middle_name": "H",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-07",
"last_updated": "2026-09-07",
"certification_date": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P5508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.