Active NPI
Kevin Nathan Yearsley, PHARM.D
- Pharmacist
- Rupert, ID
National Provider Identifier
1881851327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P5757
- Practice address
- 310 Oneida St
Rupert, ID 83350-1756 - Phone
- (208) 436-1200
- Fax
- (208) 436-6121
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- No
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 | P5757 | ID | Primary |
Addresses
Primary practice location
310 Oneida St
Rupert, ID 83350-1756
Mailing address
310 Oneida St
Rupert, ID 83350-1756
Phone (208) 436-1200
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 |
|---|---|---|---|
| P5757 | ID | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridley'S Family Markets, Inc | Past | Accepting new patients | |
| Ridleys Family Markets 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 and National Provider Directory roles.
-
dba Ridley's Pharmacy #8447
- Community/Retail Pharmacy
- Rupert, ID
- NPI 1730215070
-
dba Ridleys Pharmacy #8446
- Community/Retail Pharmacy
- Buhl, ID
- NPI 1609196351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1881851327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 ONEIDA ST",
"city": "RUPERT",
"state": "ID",
"postal_code": "833501756",
"telephone_number": "208-436-1200",
"fax_number": "208-436-6121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 ONEIDA ST",
"city": "RUPERT",
"state": "ID",
"postal_code": "833501756",
"telephone_number": "208-436-1200",
"fax_number": "208-436-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEARSLEY",
"first_name": "KEVIN",
"middle_name": "NATHAN",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P5757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rupert, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.