NPIMap

Individual provider Active NPI

Kathy S Eroschenko, PHARMD

  • Pharmacist
  • Boise, ID
National Provider Identifier
1265696207
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5737 Issued in ID
Practice address
1109 Broadway Ave
Boise, ID 83706-3626
Phone
(208) 947-0877
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5737 ID Primary

Addresses

Primary practice location

1109 Broadway Ave
Boise, ID 83706-3626

Mailing address

2356 E McPherson St
Meridian, ID 83642-4798
Phone (208) 610-8207

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
P5737IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ladd Family Pharmacy LLC Past Accepting new patients
Ladd Family Pharmacy LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1265696207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 E MCPHERSON ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424798",
            "telephone_number": "208-610-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063626",
            "telephone_number": "208-947-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EROSCHENKO",
        "first_name": "KATHY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5737",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 17, 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.

Verify at the official NPI Registry.