Matthew John Bauer, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P9887 Issued in ID

Practice address

4700 N Eagle Rd # T1960
Boise, ID 83713-0744

Phone

(208) 939-5149

Fax

(208) 939-5282

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1730474289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2652 S SIESTA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822968",
            "telephone_number": "330-495-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N EAGLE RD # T1960",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130744",
            "telephone_number": "208-939-5149",
            "fax_number": "208-939-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "98474",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018022",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P9887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asa Battista, ACUPUNCTURIST
• Michael A Battista, MD
• Hudson Nicole Battistoni, MS
• Frederick W Bauer, MD
• Marcy S Bauer, NP
• Joshua Michael Baugh
• Ryan Anthony Baugher, D.O.
• Stephanie Baumann
• Robyn Baumgardt, LMT
• Lauren Jean Baumgartner

• Pharmacist in Boise, ID
• Providers in Boise, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.