Keith Ryota Yamabe, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

P9707 Issued in ID

Practice address

2250 Coronado St Ste a
Idaho Falls, ID 83404-7552

Phone

(208) 542-4140

Fax

(208) 523-4203

NPI assigned

Dec 1, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1639837222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CORONADO ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047552",
            "telephone_number": "208-542-4140",
            "fax_number": "208-523-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 CORONADO ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047552",
            "telephone_number": "208-542-4140",
            "fax_number": "208-523-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMABE",
        "first_name": "KEITH",
        "middle_name": "RYOTA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "ID",
            "license": "P9707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Wright, DPT
• Sam Jensen Wright, PA
• Taylor Thomas Wright
• Holly Marie Wynn, LCSW
• Shane L Wynn, OD
• Elizabeth Yarborough, BA PSYCH/SOC
• Jeff Ybarguen, DDS
• Sheryl Lynn Yee, LCSW
• Yellowstone Care Center, Inc.
• Yellowstone Care Center, Inc.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.