NPIMap

Individual provider Active NPI

Melissa Gilleard, PHARMD

  • Pharmacist
  • Caldwell, ID
National Provider Identifier
1922405786
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P7162 Issued in ID
Practice address
1012 Cleveland Blvd
Caldwell, ID 83605-3852
Phone
(208) 455-1792
Fax
(208) 459-2029
NPI assigned
Nov 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P7162 ID Primary
Pharmacist 183500000X PHA-PHA-LIC-25266 MT

Addresses

Primary practice location

1012 Cleveland Blvd
Caldwell, ID 83605-3852

Mailing address

1323 S Maple Grove Rd
Boise, ID 83709-1610
Phone (208) 319-0967

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
P7162IDMDPharmacist
PHA-PHA-LIC-25266MTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1922405786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 S MAPLE GROVE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091610",
            "telephone_number": "208-319-0967",
            "fax_number": "208-319-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836053852",
            "telephone_number": "208-455-1792",
            "fax_number": "208-459-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEARD",
        "first_name": "MELISSA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7162",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "PHA-PHA-LIC-25266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.