Active NPI
Timothy Ryan Flynn, PHARMD
- Pharmacist
- Boise, ID
National Provider Identifier
1811141179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P5907
- Practice address
- 1650 W State St
Boise, ID 83702-4040 - Phone
- (208) 344-8660
- Fax
- (208) 344-1784
- NPI assigned
- Nov 12, 2008
- Last updated
- Nov 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P5907 | ID | Primary |
Addresses
Primary practice location
1650 W State St
Boise, ID 83702-4040
Mailing address
4082 N Bryce Canyon Ave
Meridian, ID 83646-4958
Phone (410) 241-0273
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
| License | State | Type | Specialty |
|---|---|---|---|
| P5907 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rite Aid Pharmacy 06833
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1811141179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4082 N BRYCE CANYON AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836464958",
"telephone_number": "410-241-0273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 W STATE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024040",
"telephone_number": "208-344-8660",
"fax_number": "208-344-1784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "TIMOTHY",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-12",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P5907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.