Active NPI
Stephanie Nichols, PHARM.D., BCPS, BCPP
- Psychiatric Pharmacist
- Portland, ME
National Provider Identifier
1134612633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- PR5426
- Practice address
- 22 Bramhall St
Portland, ME 04102-3175 - Phone
- (207) 662-1585
- NPI assigned
- Jun 8, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PR5426 | ME | |
| Psychiatric Pharmacist | 1835P1300X | PR5426 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3175
Mailing address
143 Smutty LN
Saco, ME 04072-9718
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 |
|---|---|---|---|
| PR5426 | ME | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1134612633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 SMUTTY LN",
"city": "SACO",
"state": "ME",
"postal_code": "040729718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023175",
"telephone_number": "207-662-1585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "STEPHANIE",
"credential": "PHARM.D., BCPS, BCPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "ME",
"license": "PR5426",
"primary": false
},
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "ME",
"license": "PR5426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.