Active NPI
Nichelle Page Wilson
- Pharmacist
- Tuscaloosa, AL
National Provider Identifier
1255935409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14513
- Practice address
- 808 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5809 - Phone
- (205) 345-0531
- Fax
- (205) 345-1068
- NPI assigned
- Nov 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 14513 | AL | Primary |
Addresses
Primary practice location
808 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5809
Mailing address
808 Veterans Memorial Pkwy
Tuscaloosa, AL 35404-5809
Phone (205) 345-0531
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | . | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14513 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama CVS Pharmacy, L.L.C. | Current | Accepting new patients | |
| Alabama CVS Pharmacy LLC | Past | Accepting new patients |
Locations
808 Veterans Memorial Pkwy
Tuscaloosa, AL 35404
Phone (205) 345-0531
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606608000000",
"number": "1255935409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 VETERANS MEMORIAL PKWY",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354045809",
"telephone_number": "205-345-0531",
"fax_number": "205-345-1068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 VETERANS MEMORIAL PKWY",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354045809",
"telephone_number": "205-345-0531",
"fax_number": "205-345-1068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "NICHELLE",
"middle_name": "PAGE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-29",
"last_updated": "2020-11-29",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "14513",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": ".",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "808 Veterans Memorial Pkwy",
"city": "Tuscaloosa",
"state": "AL",
"country_code": "US",
"postal_code": "354045809",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.