ROBERT W MICKELSON (NPI# 1205135498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205135498 |
| Entity Type | Individual |
| Full Name | ROBERT W MICKELSON |
| Practice Address |
2809 Cleveland Blvd Caldwell ID 83605-4443 |
| Mailing Address |
16122 Horizon Dr Caldwell ID 83607-8298 |
| Practice Telephone | 2084551094 |
| Practice Fax Number | 2084551097 |
| Mailing Telephone | 2084548890 |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2011-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | P5300 | ID | Pharmacy Service Providers |
| Street Address |
2809 CLEVELAND BLVD |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780879536 | Saint Alphonsus Specialty Services Inc | Nurse Practitioner | 2809 Cleveland Blvd, Caldwell, ID 83605-4443 | 2007-09-13 |
| 1194219634 | Jeramy Randall Neibaur | Pharmacist | 2809 Cleveland Blvd, Caldwell, ID 83605-4443 | 2018-06-19 |
| 1720536758 | Matthew Lorcher | Pharmacist | 2809 Cleveland Blvd, Caldwell, ID 83605-4443 | 2016-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1104239169 | Nichelle Daigle | Pharmacist | 622 E Ustick Rd, Caldwell, ID 83605 | 2014-06-08 |
| 1679910491 | Trisha M Beutler | Pharmacist | 11809 Shalako Rd, Caldwell, ID 83607-5095 | 2013-06-03 |
| 1477839405 | Chad Boughey | Pharmacist | 7017 Noah Dr Apt 201, Caldwell, ID 83607-5339 | 2011-10-21 |
| 1326335746 | Raymond Joffer | Pharmacist | 2500 Blaine St., Caldwell, ID 83605-4426 | 2011-07-06 |
| 1841519774 | Mital C Shah | Pharmacist | 356 Bloomfield Ave, Caldwell, NJ 07006-4905 | 2010-05-17 |
| 1215092044 | Rebecca Sue Dunlap | Pharmacist | 44523 Marietta Road, Caldwell, OH 43724 | 2006-12-22 |
| 1992800361 | Gregory Allen Paisley | Pharmacist | 109 West Street, Caldwell, OH 43724-1359 | 2006-09-13 |
| Find all providers in CALDWELL | ||||
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| 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.