Active NPI
Bailey D Stark, PHARMD
- Pharmacist
- Nampa, ID
National Provider Identifier
1447096151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P11318
- Practice address
- 207 1St St S
Nampa, ID 83651-3703 - Phone
- (208) 318-1376
- Fax
- (208) 465-6414
- NPI assigned
- Jul 2, 2024
- Last updated
- Jul 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P11318 | ID | Primary |
Addresses
Primary practice location
207 1St St S
Nampa, ID 83651-3703
Mailing address
PO Box 9
Nampa, ID 83653-0009
Phone (208) 467-4431
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 |
|---|---|---|---|
| P11318 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1447096151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9",
"city": "NAMPA",
"state": "ID",
"postal_code": "836530009",
"telephone_number": "208-467-4431",
"fax_number": "208-466-5359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 1ST ST S",
"city": "NAMPA",
"state": "ID",
"postal_code": "836513703",
"telephone_number": "208-318-1376",
"fax_number": "208-465-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "BAILEY",
"middle_name": "D",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P11318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.