NPIMap

Organization Active NPI

Gooding Pharmacy Inc

Doing business as Gooding Pharmacy

  • Community/Retail Pharmacy
  • Gooding, ID
National Provider Identifier
1417333501
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
40040RP Issued in ID
Legal business name
GOODING PHARMACY INC
Doing business as
Gooding Pharmacy
Practice address
445 Main St
Gooding, ID 83330-1304
Phone
(208) 934-4000
Fax
(208) 934-8899
NPI assigned
Jul 31, 2015
Last updated
Nov 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Jason Reading, PHARM-D
Title
President
Phone
(208) 681-5897

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 40040RP ID Primary

Addresses

Primary practice location

445 Main St
Gooding, ID 83330-1304

Mailing address

445 Main St
Gooding, ID 83330-1304
Phone (208) 934-4000

Other identifiers 2

IdentifierTypeStateIssuer
1417333501MedicaidID
2153679OtherPK

Other names 1

  • Gooding Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200721001209 ID Part B Supplier - Mass Immunization (Roster Biller Only) 0143644393 3 other NPIs on this enrollment
Practice locations: Gooding, ID; Hagerman, ID; Shoshone, ID; Twin Falls, ID

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gooding Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

445 Main St
Gooding, ID 83330
Phone (208) 934-4000

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1417333501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301304",
            "telephone_number": "208-934-4000",
            "fax_number": "208-934-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301304",
            "telephone_number": "208-934-4000",
            "fax_number": "208-934-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODING PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "READING",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-681-5897",
        "authorized_official_credential": "PHARM-D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "40040RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417333501",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gooding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gooding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gooding, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.