Individual provider Active NPI

Kayla Dotson, PHARMD

  • Pharmacist
  • Sandpoint, ID
National Provider Identifier
1720495807
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5625 Issued in ID
Practice address
810 Sixth Ave
Sandpoint, ID 83864-5396
Phone
(208) 265-1400
Fax
(208) 263-2497
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5625 ID Primary

Addresses

Primary practice location

810 Sixth Ave
Sandpoint, ID 83864-5396

Mailing address

PO Box 371
Sagle, ID 83860-0371
Phone (208) 255-7080

Other practice location 1

6612 Comanche St
Bonners Ferry, ID 83805-7523
Phone (986) 235-0689

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
P5625IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Boundary Regional Community Health Center, Inc. PastSince Feb 25, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1720495807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371",
            "city": "SAGLE",
            "state": "ID",
            "postal_code": "838600371",
            "telephone_number": "208-255-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SIXTH AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645396",
            "telephone_number": "208-265-1400",
            "fax_number": "208-263-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6612 Comanche St",
            "address_purpose": "LOCATION",
            "city": "Bonners Ferry",
            "state": "ID",
            "postal_code": "838057523",
            "country_code": "US",
            "telephone_number": "986-235-0689",
            "fax_number": "208-601-1086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "KAYLA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.