Active NPI
Monica Graybeal, PHA
- Pharmacist
- Coeur d'Alene, ID
National Provider Identifier
1902279904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6156
- Practice address
- 1090 W Park PL
Coeur D Alene, ID 83814-2785 - Phone
- (208) 215-2005
- Fax
- (844) 807-3782
- NPI assigned
- Nov 12, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 60018594 | WA | |
| Pharmacist | 183500000X | P6156 | ID | Primary |
Addresses
Primary practice location
1090 W Park PL
Coeur D Alene, ID 83814-2785
Mailing address
PO Box 1387
Hayden, ID 83835-1387
Phone (086) 205-2502
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 |
|---|---|---|---|
| P6156 | ID | MD | Pharmacist |
| 60018594 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669680000000",
"number": "1902279904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1387",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838351387",
"telephone_number": "086-205-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1090 W PARK PL",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142785",
"telephone_number": "208-215-2005",
"fax_number": "844-807-3782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYBEAL",
"first_name": "MONICA",
"credential": "PHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-12",
"last_updated": "2022-11-29",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "60018594",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6156",
"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 Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.