Individual provider Active NPI

Cheyanne Jane Williams, PHARMD

  • Pharmacist
  • Pocatello, ID
National Provider Identifier
1659855450
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P8072 Issued in ID
Practice address
1465 Bannock Hwy
Pocatello, ID 83204-5077
Phone
(208) 233-2444
NPI assigned
Sep 18, 2018
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P8072 ID Primary

Addresses

Primary practice location

1465 Bannock Hwy
Pocatello, ID 83204-5077

Mailing address

760 Park Ave
Pocatello, ID 83201-3763
Phone (208) 680-9039

Other practice location 1

4215 Yellowstone Ave
Pocatello, ID 83202-2419
Phone (208) 237-6828

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
P8072IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Keymed Inc Past Accepting new patients

Organizations & group practices 1

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1659855450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 PARK AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013763",
            "telephone_number": "208-680-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 BANNOCK HWY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832045077",
            "telephone_number": "208-233-2444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4215 Yellowstone Ave",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832022419",
            "country_code": "US",
            "telephone_number": "208-237-6828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CHEYANNE",
        "middle_name": "JANE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P8072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.