Active NPI
Mark Melgaard, RPH
- Pharmacist
- Boulder City, NV
National Provider Identifier
1144825647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15674
- Practice address
- 1017 Nevada Way
Boulder City, NV 89005-1801 - Phone
- (702) 293-6705
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15674 | NV | Primary |
Addresses
Primary practice location
1017 Nevada Way
Boulder City, NV 89005-1801
Mailing address
684 Vortex Ave
Henderson, NV 89002-6563
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15674 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nevada CVS Pharmacy LLC | Current | Accepting new patients | |
| Nevada CVS Pharmacy LLC | Past | Accepting new patients |
Locations
1017 Nevada Way
Boulder City, NV 89005
Phone (702) 293-6705
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": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1144825647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "684 VORTEX AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890026563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 NEVADA WAY",
"city": "BOULDER CITY",
"state": "NV",
"postal_code": "890051801",
"telephone_number": "702-293-6705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELGAARD",
"first_name": "MARK",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "15674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder City, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.