Samuel Michael Wilde, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

23475 Issued in NV

Practice address

340 Falcon Ridge Pkwy Ste 403
Mesquite, NV 89027-8851

Phone

(435) 668-8867

NPI assigned

Jul 17, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Mesa Ridge, LLC

  • Long Term Care Pharmacy
  • Mesquite, NV
  • NPI 1497567143
  NPD Authorized official
• Mesa Ridge, LLC

  • Community/Retail Pharmacy
  • Mesquite, NV
  • NPI 1750064622
  NPD Authorized official

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1346929320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY STE 403",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278851",
            "telephone_number": "435-668-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY STE 403",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278851",
            "telephone_number": "435-668-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "SAMUEL",
        "middle_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "9765691-1701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "23475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walmart Inc.
• West Michigan Emdr Therapy and Consulting PLLC
• Trevor White, DDS
• Chet S Wier, PH.D
• Stephanie Wilde
• Williams, Linda M. M. Williams, Linda M.
• Cindy M Wilson
• Kimberley Witter, AMFT
• Teri Wong

• Pharmacist in Mesquite, NV
• Providers in Mesquite, NV by specialty
• Pharmacist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.