Individual provider Active NPI

Kelly Langerak, PHARM.D.

  • Pharmacist
  • Boise, ID
National Provider Identifier
1578997276
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6787 Issued in ID
Practice address
10555 W Overland Rd
Walgreens
Boise, ID 83709-1436
Phone
(208) 321-2669
NPI assigned
Aug 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6787 ID Primary

Addresses

Primary practice location

10555 W Overland Rd
Walgreens
Boise, ID 83709-1436

Mailing address

10555 W Overland Rd
Walgreens
Boise, ID 83709-1436
Phone (208) 321-2669

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
6787IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1578997276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 W OVERLAND RD",
            "address_2": "WALGREENS",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091436",
            "telephone_number": "208-321-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 W OVERLAND RD",
            "address_2": "WALGREENS",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091436",
            "telephone_number": "208-321-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGERAK",
        "first_name": "KELLY",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "6787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.