Individual provider Active NPI

Lisa McBeth

  • Pharmacist
  • Chubbuck, ID
National Provider Identifier
1972903078
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P4910 Issued in ID
Practice address
4240 Yellowstone Ave
Chubbuck, ID 83202-2420
Phone
(208) 237-5091
Fax
(208) 237-6897
NPI assigned
Aug 26, 2014
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 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 P4910 ID Primary

Addresses

Primary practice location

4240 Yellowstone Ave
Chubbuck, ID 83202-2420

Mailing address

4240 Yellowstone Ave
Chubbuck, ID 83202-2420
Phone (208) 237-5091

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

LicenseStateTypeSpecialty
P4910IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1972903078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022420",
            "telephone_number": "208-237-5091",
            "fax_number": "208-237-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022420",
            "telephone_number": "208-237-5091",
            "fax_number": "208-237-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBETH",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P4910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.