NPIMap

Organization Active NPI

Nudak Ventures, LLC

Doing business as NuCara Pharmacy #17

  • Home Infusion Agency
  • Austin, TX
National Provider Identifier
1063423614
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
NUDAK VENTURES, LLC
Doing business as
NuCara Pharmacy #17
Practice address
6111 Burnet Rd
Austin, TX 78757-3226
Phone
(512) 454-9923
Fax
(512) 454-9866
NPI assigned
Aug 10, 2006
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Lori Ann Willis
Title
Acquisitions Manager
Phone
(641) 366-3440

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X 28221 TX
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Pharmacy 333600000X NU
Home Infusion Therapy Pharmacy 3336H0001X NU

Addresses

Primary practice location

6111 Burnet Rd
Austin, TX 78757-3226

Mailing address

6111 Burnet Rd
Austin, TX 78757-3226
Phone (512) 454-9923

Other identifiers 1

IdentifierTypeStateIssuer
2141583OtherPK

Other names 1

  • NuCara Pharmacy #17 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130703000347 TX DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 5395907141 Practice locations: Austin, TX

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Nucara Pharmacy #176111 Burnet Rd, Austin, TX 78757-3226(512) 454-9923 Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Does not accept assignmentParticipating since Jan 1, 2021

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1063423614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573226",
            "telephone_number": "512-454-9923",
            "fax_number": "512-454-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787573226",
            "telephone_number": "512-454-9923",
            "fax_number": "512-454-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDAK VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "LORI ANN",
        "authorized_official_title_or_position": "ACQUISITIONS MANAGER",
        "authorized_official_telephone_number": "641-366-3440"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "28221",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141583",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuCara Pharmacy #17",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NuCara Pharmacy #17",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.