Active NPI
John Nicolette Jr.
- Pharmacist
- El Dorado Hills, CA
National Provider Identifier
1033587498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73065
- Practice address
- 3383 Bass Lake Rd
El Dorado Hills, CA 95762-6623 - Phone
- (530) 313-4925
- NPI assigned
- Sep 2, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 73065 | CA | Primary |
Addresses
Primary practice location
3383 Bass Lake Rd
El Dorado Hills, CA 95762-6623
Mailing address
3383 Bass Lake Rd
El Dorado Hills, CA 95762-6623
Phone (530) 313-4925
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73065 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Current | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Locations
3383 Bass Lake Rd
El Dorado Hills, CA 95762
Phone (530) 313-4925
Organizations & group practices 4
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.
-
dba Rite Aid Pharmacy 06833
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
-
dba Rite Aid Pharmacy 06058
- Community/Retail Pharmacy
- Placerville, CA
- NPI 1598874992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662249600000",
"number": "1033587498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3383 BASS LAKE RD",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957626623",
"telephone_number": "530-313-4925",
"fax_number": "530-313-4926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3383 BASS LAKE RD",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957626623",
"telephone_number": "530-313-4925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLETTE",
"first_name": "JOHN",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-02",
"last_updated": "2022-09-04",
"certification_date": "2022-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.