Individual provider Active NPI

Eizabeth A Keller, PHARMD

  • Pharmacist
  • Post Falls, ID
National Provider Identifier
1508292731
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00055898 Issued in WA
Practice address
708 East Seltice Way
Post Falls, ID 83854
Phone
(208) 777-4071
Fax
(208) 773-0913
NPI assigned
Sep 19, 2013
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00055898 WA Primary
Pharmacist 183500000X 18591 CO

Addresses

Primary practice location

708 East Seltice Way
Post Falls, ID 83854

Mailing address

708 East Seltice Way
Post Falls, ID 83854
Phone (208) 777-4071

Other identifiers 2

IdentifierTypeStateIssuer
18591OtherCOLICENSE
PH00055898OtherWALICENSE

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
18591COMDPharmacist
PH00055898WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1508292731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 EAST SELTICE WAY",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-777-4071",
            "fax_number": "208-773-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 EAST SELTICE WAY",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-777-4071",
            "fax_number": "208-773-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "EIZABETH",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00055898",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "18591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "18591",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PH00055898",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.