Active NPI
Kristen Demaline, PHARMD
- Pharmacist
- Coeur d'Alene, ID
National Provider Identifier
1346848546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P9340
- Practice address
- 1001 N 4TH St
Coeur D Alene, ID 83814-3113 - Phone
- (208) 667-3860
- NPI assigned
- Oct 12, 2020
- Last updated
- Jun 22, 2021
- 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 | 5302412519 | MI | |
| Pharmacist | 183500000X | P9340 | ID | Primary |
Addresses
Primary practice location
1001 N 4TH St
Coeur D Alene, ID 83814-3113
Mailing address
1001 N 4TH St
Coeur D Alene, ID 83814-3113
Phone (208) 667-3860
Other practice location 1
41460 Haggerty Cir S
Canton, MI 48188-2227
Phone (888) 282-5166
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 |
|---|---|---|---|
| P9340 | ID | MD | Pharmacist |
| 5302412519 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | 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, 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": "1602460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1346848546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 N 4TH ST",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838143113",
"telephone_number": "208-667-3860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N 4TH ST",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838143113",
"telephone_number": "208-667-3860"
}
],
"practiceLocations": [
{
"address_1": "41460 Haggerty Cir S",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "MI",
"postal_code": "481882227",
"country_code": "US",
"telephone_number": "888-282-5166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMALINE",
"first_name": "KRISTEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-12",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302412519",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P9340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur d'Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.