Active NPI
Garret Portela
- Pharmacist
- Rigby, ID
National Provider Identifier
1912319799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0014200
- Practice address
- 150 N State St
Rigby, ID 83442-1443 - Phone
- (208) 745-0267
- NPI assigned
- May 28, 2014
- Last updated
- Aug 31, 2016
- 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 | RPH-0014200 | OR | Primary |
Addresses
Primary practice location
150 N State St
Rigby, ID 83442-1443
Mailing address
1547 John Adams Pkwy
Idaho Falls, ID 83401-4284
Phone (208) 351-7284
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 |
|---|---|---|---|
| RPH-0014200 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1912319799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 JOHN ADAMS PKWY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834014284",
"telephone_number": "208-351-7284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N STATE ST",
"city": "RIGBY",
"state": "ID",
"postal_code": "834421443",
"telephone_number": "208-745-0267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTELA",
"first_name": "GARRET",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-28",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0014200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rigby, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.