Sage Davis, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2961973 Issued in ID

Practice address

305 W Quinn Rd
Pocatello, ID 83201-4988

Phone

(208) 238-4049

NPI assigned

Dec 12, 2024

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sage Nielson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1407663586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211799",
            "telephone_number": "208-785-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W QUINN RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014988",
            "telephone_number": "208-238-4049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Blackfoot",
            "state": "ID",
            "postal_code": "832211799",
            "country_code": "US",
            "telephone_number": "208-785-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAGE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "2961973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAGE",
            "last_name": "NIELSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cameron Davis
• Charles M Davis Jr., RPH
• Christopher Sean Davis, LMSW
• Darrell Wade Davis, D.C.
• Gina Marie Davis, PHARM.D.
• Stephanie Ann Davis, MOTR/L
• Thomas Vance Davis, D.O.
• Myla Day, LMSW
• Bo Dayton, DO
• Mary Ann Mendoza De Guzman, OT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.