NPIMap

Organization Active NPI

Nudak Ventures LLC

  • Community/Retail Pharmacy
  • Nevada, IA
National Provider Identifier
1104837616
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
482 Issued in IA
Legal business name
NUDAK VENTURES LLC
Practice address
1002 6TH St
Nevada, IA 50201-1826
Phone
(515) 382-2485
Fax
(515) 382-3473
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Authorized official

Name
Lori Willis
Title
Acquisitions Manager
Phone
(515) 280-2927

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 482 IA Primary

Addresses

Primary practice location

1002 6TH St
Nevada, IA 50201-1826

Mailing address

PO Box 640
Conrad, IA 50621-0640
Phone (641) 366-3440

Other identifiers 2

IdentifierTypeStateIssuer
0181032MedicaidIA
2136153OtherPK

Other names 1

  • NuCara Pharmacy #9 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120914000317 IA DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & Equipment 5395907141 Practice locations: Nevada, IA
O20131111001001 IA Part B Supplier - Mass Immunization (Roster Biller Only) 5395907141 23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conrad, IA; Ackley, IA; Zearing, IA; West Union, IA; Waterloo, IA; Traer, IA; Story City, IA; Pleasant Hill, IA…
O20220419002811 IA Part B Supplier - Independent Clinical Laboratory 5395907141 16 other NPIs on this enrollment
Practice locations: Zearing, IA; West Union, IA; Waterloo, IA; Traer, IA; Story City, IA; Pleasant Hill, IA; Ottumwa, IA; Nevada, IA…

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Nudak Ventures LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

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": "1781481600000",
    "number": "1104837616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "CONRAD",
            "state": "IA",
            "postal_code": "506210640",
            "telephone_number": "641-366-3440",
            "fax_number": "641-366-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 6TH ST",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502011826",
            "telephone_number": "515-382-2485",
            "fax_number": "515-382-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDAK VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACQUISITIONS MANAGER",
        "authorized_official_telephone_number": "515-280-2927"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181032",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136153",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuCara Pharmacy #9",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nevada, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.