Individual provider Active NPI

Christopher Waag, PHARMD

  • Pharmacist
  • Eagle, ID
National Provider Identifier
1801773049
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P10807 Issued in ID
Practice address
44 N Fisher Park Way Ste a
Eagle, ID 83616-4704
Phone
(208) 593-0133
Fax
(866) 922-8196
NPI assigned
Aug 19, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P10807 ID Primary

Addresses

Primary practice location

44 N Fisher Park Way Ste a
Eagle, ID 83616-4704

Mailing address

6366 N Mystic Cove PL
Garden City, ID 83714-5149
Phone (208) 921-1159

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
P10807IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1801773049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6366 N MYSTIC COVE PL",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837145149",
            "telephone_number": "208-921-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N FISHER PARK WAY STE A",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164704",
            "telephone_number": "208-593-0133",
            "fax_number": "866-922-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAAG",
        "first_name": "CHRISTOPHER",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P10807",
            "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 19, 2025; 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.