Individual provider Active NPI

Jeremy Crowfoot, PHARM.D.

  • Pharmacist
  • Boise, ID
National Provider Identifier
1376079004
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P6693 Issued in ID
Practice address
5966 W Curtisian Ave
Boise, ID 83704-8801
Phone
(208) 302-5470
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P6693 ID Primary
Pharmacist 183500000X RPH-0013943 OR

Addresses

Primary practice location

5966 W Curtisian Ave
Boise, ID 83704-8801

Mailing address

5966 W Curtisian Ave
Boise, ID 83704-8801

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
P6693IDMDPharmacist
RPH-0013943ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1376079004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5966 W CURTISIAN AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5966 W CURTISIAN AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048801",
            "telephone_number": "208-302-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWFOOT",
        "first_name": "JEREMY",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6693",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0013943",
            "primary": false
        }
    ],
    "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 May 1, 2017; 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.