Individual provider Active NPI

Scott Allen Porter, R PH PHARM D

  • Pharmacist
  • Sandpoint, ID
National Provider Identifier
1326035494
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5055 Issued in ID
Practice address
604 N 5TH Ave
Sandpoint, ID 83864-1520
Phone
(208) 263-1408
Fax
(208) 265-8784
NPI assigned
Oct 4, 2005
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5055 ID Primary

Addresses

Primary practice location

604 N 5TH Ave
Sandpoint, ID 83864-1520

Mailing address

604 N Fifth Ave
Sandpoint, ID 83864-1520
Phone (208) 263-1408

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
P5055IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandpoint Super Drug Clinical CurrentSince Mar 13, 2022 Accepting new patients
Sandpoint Drug Inc Pharmacist CurrentSince Mar 13, 2022 Accepting new patients

Locations

604 N Fifth Ave
Sandpoint, ID 83864
Phone (208) 263-1408

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1326035494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N FIFTH AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641520",
            "telephone_number": "208-263-1408",
            "fax_number": "208-265-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N 5TH AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838641520",
            "telephone_number": "208-263-1408",
            "fax_number": "208-265-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SCOTT",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "R PH PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.