DR. KRISTY LYNN FORDYCE (NPI# 1144495615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144495615 |
| Entity Type | Individual |
| Full Name | DR. KRISTY LYNN FORDYCE |
| Credential | PHARMD |
| Practice Address |
800 Yellowstone Ave Pocatello ID 83201-4433 |
| Practice Telephone | 2082394033 |
| Practice Fax Number | 2082394027 |
| Mailing Telephone | 2082394033 |
| Mailing Fax Number | 2082394027 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | P5254 | ID | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
P5254 | ID | Pharmacy Service Providers |
| Street Address |
800 YELLOWSTONE AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508850322 | George N Sedlmayer | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4415 | 2005-09-08 |
| 1699300392 | James Miles | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2020-03-03 |
| 1063970929 | Jeffrey R Plante | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2019-03-08 |
| 1033483292 | Spencer Adams | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2012-03-05 |
| 1982974747 | Karla Quia-park | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2012-01-10 |
| 1487953816 | Jerry T Holland Jr. | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-24 |
| 1396044079 | Jared G Turner | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-21 |
| 1548569569 | Thomas Allen Manske | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-16 |
| 1740225275 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1417595067 | Teresa Janeen Newsom | Pharmacist | 2840 S Swallowtail Ln, Boise, ID 83706-6138 | 2019-12-13 |
| 1255714879 | Kristin Helmboldt | Pharmacist | 2309 E Cyanite Dr, Meridian, ID 83642-9072 | 2015-07-01 |
| 1932480431 | Amy Anne Mcdougal | Pharmacist | 1066 N Yellowstone Hwy, Rexburg, ID 83440-5103 | 2011-08-30 |
| 1932496650 | Charlotte Loring | Pharmacist | 909 E Park Center B;vd, Boise, ID 83706 | 2011-07-01 |
| 1215237144 | Jacqueline K Kavila | Pharmacist | 2809 E. Cleveland Blvd, Caldwell, ID 83605 | 2010-10-26 |
| 1508096777 | Kim E. Tillery | Pharmacist | 2638 Longbow Dr, Twin Falls, ID 83301-8946 | 2009-07-21 |
| 1093314866 | Gregory Aaron Carter | Pharmacist | 2327 Coronado St, Idaho Falls, ID 83404-7407 | 2020-10-22 |
| 1316544604 | James K Hunter | Pharmacist | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2020-10-08 |
| 1629689799 | Tanna Marie Schlader | Pharmacist | 50 2nd St S, Nampa, ID 83651-3700 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KRISTY LYNN FORDYCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.