Individual provider Active NPI

Nick Jason Reif, PHARM. D

  • Pharmacist
  • Eureka, CA
National Provider Identifier
1437566643
Registry record updated Jul 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66971 Issued in CA
Practice address
3300 Broadway
Bayshore Mall
Eureka, CA 95501-3809
Phone
(707) 832-5274
Fax
(707) 832-5270
NPI assigned
Jul 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66971 CA Primary

Addresses

Primary practice location

3300 Broadway
Bayshore Mall
Eureka, CA 95501-3809

Mailing address

3300 Broadway
Bayshore Mall
Eureka, CA 95501-3809
Phone (707) 832-5274

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
66971CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405814400000",
    "number": "1437566643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BROADWAY",
            "address_2": "BAYSHORE MALL",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013809",
            "telephone_number": "707-832-5274",
            "fax_number": "707-832-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 BROADWAY",
            "address_2": "BAYSHORE MALL",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013809",
            "telephone_number": "707-832-5274",
            "fax_number": "707-832-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIF",
        "first_name": "NICK",
        "middle_name": "JASON",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-20",
        "last_updated": "2014-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2014; 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.