Active NPI
Roy Weatherston, RPH
- Pharmacist
- Rexburg, ID
National Provider Identifier
1952712440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P-4245
- Practice address
- 490 N 2ND E
Rexburg, ID 83440-1654 - Phone
- (208) 542-2088
- NPI assigned
- May 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | P-4245 | ID | Primary |
Addresses
Primary practice location
490 N 2ND E
Rexburg, ID 83440-1654
Mailing address
85 E Sunset Cir
Rexburg, ID 83440-9683
Phone (208) 356-7746
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P-4245 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400457600000",
"number": "1952712440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 E SUNSET CIR",
"city": "REXBURG",
"state": "ID",
"postal_code": "834409683",
"telephone_number": "208-356-7746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 N 2ND E",
"city": "REXBURG",
"state": "ID",
"postal_code": "834401654",
"telephone_number": "208-542-2088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERSTON",
"first_name": "ROY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2014-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P-4245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.