Active NPI
Michelle Dawn Roberge, CPHT
- Clinical Pharmacology Physician
- Post Falls, ID
National Provider Identifier
1891276804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pharmacology Physician
- License
- CT17612
- Practice address
- 706 E Seltice Way
Post Falls, ID 83854-8674 - Phone
- (208) 777-4071
- Fax
- (208) 773-0913
- NPI assigned
- Aug 27, 2018
- Last updated
- Aug 27, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Pharmacology Physician | 208U00000X | CT17612 | ID | Primary |
Addresses
Primary practice location
706 E Seltice Way
Post Falls, ID 83854-8674
Mailing address
706 E Seltice Way
Post Falls, ID 83854-8674
Phone (208) 777-4071
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT17612 | ID | MD | Clinical Pharmacology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1891276804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 E SELTICE WAY",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838548674",
"telephone_number": "208-777-4071",
"fax_number": "208-773-0913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 E SELTICE WAY",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838548674",
"telephone_number": "208-777-4071",
"fax_number": "208-773-0913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERGE",
"first_name": "MICHELLE",
"middle_name": "DAWN",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "208U00000X",
"taxonomy_group": "",
"desc": "Clinical Pharmacology",
"state": "ID",
"license": "CT17612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.