Individual provider Active NPI

Nicole Sheldon, PHARMD

  • Pharmacist
  • Amery, WI
National Provider Identifier
1174861389
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16709-40 Issued in WI
Practice address
204 Keller Ave N
Amery, WI 54001-1036
Phone
(715) 268-8121
Fax
(715) 268-4733
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Pharmacist 183500000X 16709-40 WI Primary

Addresses

Primary practice location

204 Keller Ave N
Amery, WI 54001-1036

Mailing address

PO Box 17
Amery, WI 54001-0017

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

LicenseStateTypeSpecialty
16709-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1174861389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540010017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 KELLER AVE N",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011036",
            "telephone_number": "715-268-8121",
            "fax_number": "715-268-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "NICOLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "16709-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; 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.