Individual provider Active NPI

Korey Kreider, PHARMD

  • Pharmacist
  • Coeur D Alene, ID
National Provider Identifier
1801340765
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P7060 Issued in ID
Practice address
2925 W Rimbaud Ave
Coeur D Alene, ID 83815-5360
Phone
(208) 660-3938
NPI assigned
Aug 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P7060 ID Primary

Addresses

Primary practice location

2925 W Rimbaud Ave
Coeur D Alene, ID 83815-5360

Mailing address

2925 W Rimbaud Ave
Coeur D Alene, ID 83815-5360
Phone (208) 660-3938

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
P7060IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1801340765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 W RIMBAUD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838155360",
            "telephone_number": "208-660-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 W RIMBAUD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838155360",
            "telephone_number": "208-660-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIDER",
        "first_name": "KOREY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.