Active NPI
Nicole Elaine Shepherd
- Pharmacist
- Sparks, NV
National Provider Identifier
1073166625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15453
- Practice address
- 9750 Pyramid Lake Hwy
Sparks, NV 89441-7549 - Phone
- (775) 425-2727
- NPI assigned
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 15453 | NV | Primary |
Addresses
Primary practice location
9750 Pyramid Lake Hwy
Sparks, NV 89441-7549
Mailing address
2769 Silverton Way
Sparks, NV 89436-7417
Phone (775) 232-9590
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 |
|---|---|---|---|
| 15453 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1073166625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2769 SILVERTON WAY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894367417",
"telephone_number": "775-232-9590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9750 PYRAMID LAKE HWY",
"city": "SPARKS",
"state": "NV",
"postal_code": "894417549",
"telephone_number": "775-425-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "NICOLE",
"middle_name": "ELAINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NV",
"license": "15453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.