Individual provider Active NPI

Mary Elizabeth Nikolai, RPH

  • Pharmacist
  • Inver Grove Heights, MN
National Provider Identifier
1053698035
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
112844 Issued in MN
Practice address
5825 Cahill Ave
Inver Grove Heights, MN 55076-1515
Phone
(651) 451-1503
Fax
(651) 451-3650
NPI assigned
Nov 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 112844 MN Primary

Addresses

Primary practice location

5825 Cahill Ave
Inver Grove Heights, MN 55076-1515

Mailing address

5825 Cahill Ave
Inver Grove Heights, MN 55076-1515
Phone (651) 451-1503

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

LicenseStateTypeSpecialty
112844MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1053698035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 CAHILL AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761515",
            "telephone_number": "651-451-1503",
            "fax_number": "651-451-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 CAHILL AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761515",
            "telephone_number": "651-451-1503",
            "fax_number": "651-451-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLAI",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "112844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.