Active NPI
David Flint Iverson, PHARM D
- Pharmacist
- Pocatello, ID
National Provider Identifier
1679891519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E13394
- Practice address
- 12746 N Hawthorne Rd
Pocatello, ID 83202-5160 - Phone
- (208) 851-0957
- NPI assigned
- May 16, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E13394 | ID | Primary |
Addresses
Primary practice location
12746 N Hawthorne Rd
Pocatello, ID 83202-5160
Mailing address
12746 N Hawthorne Rd
Pocatello, ID 83202-5160
Phone (208) 851-0957
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
| License | State | Type | Specialty |
|---|---|---|---|
| E13394 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273968000000",
"number": "1679891519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12746 N HAWTHORNE RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832025160",
"telephone_number": "208-851-0957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12746 N HAWTHORNE RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832025160",
"telephone_number": "208-851-0957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVERSON",
"first_name": "DAVID",
"middle_name": "FLINT",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-16",
"last_updated": "2010-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "E13394",
"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 May 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.