Dustin Hannawalt

Primary specialty

PharmacistTaxonomy code 183500000X

License

P9379 Issued in ID

Practice address

4110 S 10TH Ave
Caldwell, ID 83605-5706

Phone

(208) 402-0154

NPI assigned

Jul 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Caldwell, ID
  • NPI 1902087794
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1285205377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 S 10TH AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055706",
            "telephone_number": "208-402-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 S 10TH AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836055706",
            "telephone_number": "208-402-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAWALT",
        "first_name": "DUSTIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P9379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Hammond
• Emily Hammond, RN
• Richard D Hammond, LSW
• Sheila D Hancock, LMSW
• Brandon Hanley
• Robert G Hansen, MD
• Wesley Harding
• Ryan W. Hardy, M.D.
• Myrna Lou Harrington, O.T.
• Camille Elizabeth Harris, DPM

• Pharmacist in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.