NPIMap

Individual provider Active NPI

Robert George Nolan, RPH.

  • Pharmacist
  • Davenport, IA
National Provider Identifier
1144582545
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13960 Issued in IA
Practice address
250 E 90TH St
Davenport, IA 52806-7340
Phone
(563) 285-2613
Fax
(563) 285-2655
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13960 IA Primary
Pharmacist 183500000X 22453 TN
Pharmacist 183500000X 15918 AZ
Pharmacist 183500000X 12143 NE
Pharmacist 183500000X T-12306 MS
Pharmacist 183500000X 14159 KY
Pharmacist 183500000X 11724 OR

Addresses

Primary practice location

250 E 90TH St
Davenport, IA 52806-7340

Mailing address

250 E 90TH St
Davenport, IA 52806-7340
Phone (563) 285-2613

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
12143NEMDMental Health Counselor
15918AZMDPharmacist
13960IAMDPharmacist
14159KYMDPharmacist
T-12306MSMDPharmacist
11724ORMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Apac Customer Services, Inc. Past Accepting new patients
Apac Customer SVCS Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1144582545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E 90TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528067340",
            "telephone_number": "563-285-2613",
            "fax_number": "563-285-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E 90TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528067340",
            "telephone_number": "563-285-2613",
            "fax_number": "563-285-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "ROBERT",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "RPH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "13960",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "22453",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "15918",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12143",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "T-12306",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "14159",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "11724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.