Individual provider Active NPI

Julie Eisele, PHARM.D.

  • Pharmacist
  • Eagle, ID
National Provider Identifier
1801089339
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5790 Issued in ID
Practice address
1348 W Stafford Dr
Eagle, ID 83616-6487
Phone
(208) 939-8533
NPI assigned
Aug 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5790 ID Primary

Addresses

Primary practice location

1348 W Stafford Dr
Eagle, ID 83616-6487

Mailing address

1348 W Stafford Dr
Eagle, ID 83616-6487
Phone (208) 939-8533

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
P5790IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1801089339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 W STAFFORD DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166487",
            "telephone_number": "208-939-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 W STAFFORD DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166487",
            "telephone_number": "208-939-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISELE",
        "first_name": "JULIE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.