Individual provider Active NPI

Jessica Alba, PHARMD

  • Pharmacist
  • Idaho Falls, ID
National Provider Identifier
1639805641
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P11280 Issued in ID
Practice address
590 E 17TH St
Idaho Falls, ID 83404-6154
Phone
(208) 523-1090
NPI assigned
Aug 1, 2022
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6618851-1701 UT
Pharmacist 183500000X P11280 ID Primary

Addresses

Primary practice location

590 E 17TH St
Idaho Falls, ID 83404-6154

Mailing address

500 S Utah Ave
Idaho Falls, ID 83402-3305
Phone (208) 528-8703

Other practice location 1

490 N 2nd E
Rexburg, ID 83440-1654
Phone (208) 542-2088

Other practice location 2

1901 S 25th E
Ammon, ID 83406-5710
Phone (208) 524-1616

Other practice location 3

330 E Benton St
Pocatello, ID 83201-6526
Phone (208) 233-0651

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
P11280IDMDPharmacist
6618851-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Albertsons LLC Past Accepting new patients
Harmon City Inc PastSince Aug 1, 2022 Accepting new patients
Harmon City Inc PastSince Aug 1, 2022 Accepting new patients

Organizations & group practices 3

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1639805641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023305",
            "telephone_number": "208-528-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046154",
            "telephone_number": "208-523-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 N 2nd E",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401654",
            "country_code": "US",
            "telephone_number": "208-542-2088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S 25th E",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834065710",
            "country_code": "US",
            "telephone_number": "208-524-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 E Benton St",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832016526",
            "country_code": "US",
            "telephone_number": "208-233-0651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALBA",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6618851-1701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P11280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.