Active NPI
Vicki Gail Davis, RPH
- Pharmacist
- Lewiston, ID
National Provider Identifier
1720290257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P5631
- Practice address
- 1904 19TH Ave
Lewiston, ID 83501 - Phone
- (208) 743-9127
- Fax
- (208) 743-4777
- NPI assigned
- May 4, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P5631 | ID | Primary |
| Pharmacist | 183500000X | 13219 | CO | |
| Pharmacist | 183500000X | 5291 | NM |
Addresses
Primary practice location
1904 19TH Ave
Lewiston, ID 83501
Mailing address
2178 23Rd St
Clarkston, WA 99403
Phone (509) 751-0114
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P5631 | ID | MD | Pharmacist |
| 5291 | NM | MD | Pharmacist |
| 13219 | CO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720290257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2178 23RD ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "99403",
"telephone_number": "509-751-0114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1904 19TH AVE",
"city": "LEWISTON",
"state": "ID",
"postal_code": "83501",
"telephone_number": "208-743-9127",
"fax_number": "208-743-4777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "VICKI",
"middle_name": "GAIL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P5631",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "13219",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "5291",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.