Kyle Barsness
Individual provider Active NPI Pharmacist · Lewiston, ID
NPI 1629705371 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1629705371
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 910087 (ID)
- Practice address
- 415 6TH St
Lewiston, ID 83501-2431 - Phone
- (208) 743-2511
- NPI assigned
- Aug 3, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 910087 | ID | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 910087 | ID | Yes |
Addresses
Primary practice location
415 6TH St
Lewiston, ID 83501-2431
Mailing address
415 6TH St
Lewiston, ID 83501-2431
NPI Registry JSON
{
"created_epoch": "1659484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1629705371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 6TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835012431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 6TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835012431",
"telephone_number": "208-743-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARSNESS",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-03",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "910087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.