NPIMap

Organization Active NPI

Nudak Ventures, LLC

Doing business as Nucara Pharmacy #10

  • Community/Retail Pharmacy
  • Story City, IA
National Provider Identifier
1124039763
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
78 Issued in IA
Legal business name
NUDAK VENTURES, LLC
Doing business as
Nucara Pharmacy #10
Practice address
621 Broad St
Story City, IA 50248-1200
Phone
(515) 733-2233
Fax
(515) 733-2366
NPI assigned
Aug 10, 2006
Last updated
Jun 15, 2026By the provider in NPPES
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
Delegated Official
Phone
(515) 280-2927

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 78 IA Primary

Addresses

Primary practice location

621 Broad St
Story City, IA 50248-1200

Mailing address

PO Box 640
Conrad, IA 50621-0640
Phone (515) 733-2233

Other identifiers 2

IdentifierTypeStateIssuer
1609847OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0181230MedicaidIA

Other names 1

  • NUCARA PHARMACY #10 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
This NPI is an additional NPI on the enrollment
Practice locations: Zearing, IA; West Union, IA; Waterloo, IA; Traer, IA; Story City, IA; Pleasant Hill, IA; Ottumwa, IA; Nevada, IA…

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

Locations

621 Broad St
Story City, IA 50248
Phone (515) 733-2233

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": "1124039763",
    "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": "515-733-2233",
            "fax_number": "515-733-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BROAD ST",
            "city": "STORY CITY",
            "state": "IA",
            "postal_code": "502481200",
            "telephone_number": "515-733-2233",
            "fax_number": "515-733-2366"
        }
    ],
    "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": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "515-280-2927"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "78",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1609847",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0181230",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NUCARA PHARMACY #10",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Story City, 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.