Active NPI
Katie Yvonne Gonzalez, RPH
- Pharmacist
- Kuna, ID
National Provider Identifier
1467024315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P9434
- Practice address
- 869 E Avalon St
Kuna, ID 83634-2141 - Phone
- (208) 319-0205
- Fax
- (208) 319-0211
- NPI assigned
- Jul 12, 2021
- Last updated
- Jul 12, 2021
- Sex
- Female
- 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 | P9434 | ID | Primary |
Addresses
Primary practice location
869 E Avalon St
Kuna, ID 83634-2141
Mailing address
869 E Avalon St
Kuna, ID 83634-2141
Phone (208) 319-0205
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P9434 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
869 E Avalon St
Kuna, ID 83634
Phone (208) 319-0205
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1467024315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "869 E AVALON ST",
"city": "KUNA",
"state": "ID",
"postal_code": "836342141",
"telephone_number": "208-319-0205",
"fax_number": "208-319-0211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "869 E AVALON ST",
"city": "KUNA",
"state": "ID",
"postal_code": "836342141",
"telephone_number": "208-319-0205",
"fax_number": "208-319-0211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KATIE",
"middle_name": "YVONNE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P9434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.