NPIMap

Individual provider Active NPI

Brady Tucker, PHARM D

  • Pharmacist
  • Kuna, ID
National Provider Identifier
1912329806
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P6825 Issued in ID
Practice address
1403 North Meridian Rd
Kuna, ID 83634
Phone
(208) 922-9566
NPI assigned
Jan 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P6825 ID Primary

Addresses

Primary practice location

1403 North Meridian Rd
Kuna, ID 83634

Mailing address

621 Washington St S
Twin Falls, ID 83301

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

LicenseStateTypeSpecialty
P6825IDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridley'S Family Markets, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1912329806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 WASHINGTON ST S",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "83301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 NORTH MERIDIAN RD",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "83634",
            "telephone_number": "208-922-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BRADY",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P6825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kuna, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.