Active NPI
Wade H Flowers Jr., PHARM.D., BCPS, CGP
- Pharmacotherapy Pharmacist
- Blackfoot, ID
National Provider Identifier
1609871474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- P4656
- Practice address
- 98 Poplar St
Blackfoot, ID 83221-1758 - Phone
- (208) 782-3770
- Fax
- (208) 782-3709
- NPI assigned
- Jun 16, 2005
- Last updated
- Apr 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | P4656 | ID | Primary |
| Geriatric Pharmacist | 1835G0303X | P4656 | ID |
Addresses
Primary practice location
98 Poplar St
Blackfoot, ID 83221-1758
Mailing address
13103 W Reservation Rd
Pocatello, ID 83202-5129
Phone (208) 238-1281
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3 08 010444 | Other | ID | BCPS |
| 1381 | Other | ID | CGP |
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 |
|---|---|---|---|
| P4656 | ID | MD | Geriatric Pharmacist |
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": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1609871474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13103 W RESERVATION RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832025129",
"telephone_number": "208-238-1281",
"fax_number": "208-782-3709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 POPLAR ST",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832211758",
"telephone_number": "208-782-3770",
"fax_number": "208-782-3709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLOWERS",
"first_name": "WADE",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARM.D., BCPS, CGP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "ID",
"license": "P4656",
"primary": true
},
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "ID",
"license": "P4656",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCPS",
"identifier": "3 08 010444",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CGP",
"identifier": "1381",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blackfoot, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.