Staci Marie Thayer, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

P8470 Issued in ID

Practice address

306 Blue Lakes Blvd N
Twin Falls, ID 83301-4827

Phone

(208) 734-4053

Fax

(208) 734-4295

NPI assigned

Nov 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Twin Falls, ID
  • NPI 1780699801
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1573948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1629613302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 BROOKSTONE ST",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025247",
            "telephone_number": "208-431-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014827",
            "telephone_number": "208-734-4053",
            "fax_number": "208-734-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "STACI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-17",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P8470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "306 Blue Lakes Blvd N",
            "city": "Twin Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833014827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony Teich, RD, LD
• Jeanette Terry, LAMFT
• Teton Healthcare, Inc.
• Teton Healthcare, Inc.
• TFLD Partners. LLC
• The Bridge Counseling, LLC
• The Climbing Tree, Inc.
• The Mama Coach Kailey LLC
• The Nova Residence Inc
• The Rock Behavioral Health

• Pharmacist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; 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.