Individual provider Active NPI

Michael Rixford Proudfoot, PHARM.D.

  • Pharmacist
  • Nampa, ID
National Provider Identifier
1457673741
Registry record updated Feb 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P6309 Issued in ID
Practice address
1813 Caldwell Blvd
Nampa, ID 83651-1505
Phone
(208) 466-4521
NPI assigned
Feb 27, 2010
Last updated
Feb 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P6309 ID Primary

Addresses

Primary practice location

1813 Caldwell Blvd
Nampa, ID 83651-1505

Mailing address

6853 N Bogart LN
Boise, ID 83714-4302
Phone (281) 253-6265

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
P6309IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1267228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267228800000",
    "number": "1457673741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 N BOGART LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837144302",
            "telephone_number": "281-253-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 CALDWELL BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511505",
            "telephone_number": "208-466-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUDFOOT",
        "first_name": "MICHAEL",
        "middle_name": "RIXFORD",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-27",
        "last_updated": "2010-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6309",
            "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 Feb 27, 2010; 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.