Individual provider Active NPI

Ryan M Shick, PHARMD

  • Pharmacist
  • Lorain, OH
National Provider Identifier
1174878490
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03131716 Issued in OH
Practice address
3600 Kolbe Rd
Suite 108
Lorain, OH 44053-1654
Phone
(440) 960-3420
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03131716 OH Primary

Addresses

Primary practice location

3600 Kolbe Rd
Suite 108
Lorain, OH 44053-1654

Mailing address

710 Jefferson Ave
Apt. 415
Cleveland, OH 44113-4616

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
03131716OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1174878490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 JEFFERSON AVE",
            "address_2": "APT. 415",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441134616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 KOLBE RD",
            "address_2": "SUITE 108",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531654",
            "telephone_number": "440-960-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHICK",
        "first_name": "RYAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03131716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.