Active NPI
Nicole Rodin, PHARMD
- Pharmacist
- Spokane, WA
National Provider Identifier
1124531645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60782161
- Practice address
- 205 E Spokane Falls Blvd
Spokane, WA 99202 - Phone
- (505) 463-3403
- NPI assigned
- Nov 6, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00008765 | NM | |
| Pharmacist | 183500000X | PH60782161 | WA | Primary |
Addresses
Primary practice location
205 E Spokane Falls Blvd
Spokane, WA 99202
Mailing address
2223 W Everett Ave
Spokane, WA 99205-5653
Phone (505) 463-3403
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH60782161 | Other | WA | WASHINGTON DEPARTMENT OF HEALTH |
| P7978 | Other | ID | IDAHO BOARD OF PHARMACY |
| RP00008765 | Other | NM | NEW MEXICO BOARD OF PHARMACY |
Other names 1
- Nicole Perea
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00008765 | NM | MD | Pharmacist |
| PH60782161 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1124531645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 W EVERETT AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992055653",
"telephone_number": "505-463-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 E SPOKANE FALLS BLVD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99202",
"telephone_number": "505-463-3403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODIN",
"first_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-06",
"last_updated": "2021-03-31",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00008765",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60782161",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON DEPARTMENT OF HEALTH",
"identifier": "PH60782161",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO BOARD OF PHARMACY",
"identifier": "P7978",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO BOARD OF PHARMACY",
"identifier": "RP00008765",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "PEREA",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.