Kim Vincent Nilsson

Primary specialty

PharmacistTaxonomy code 183500000X

License

03211210 Issued in OH

Practice address

1015 N Court St
Medina, OH 44256-1582

Phone

(330) 725-2706

Fax

(330) 725-2706

NPI assigned

Jun 14, 2011

Last updated

Jun 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1558656942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561582",
            "telephone_number": "330-725-2706",
            "fax_number": "330-725-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561582",
            "telephone_number": "330-725-2706",
            "fax_number": "330-725-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "KIM",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03211210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162443",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCO",
            "identifier": "340006148",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennie Elizabeth Nichols, D.D.S.
• Jodi Lynn Nichols
• Jovianna Nichols
• Zoeigh David Nichols
• Dawn Elaine Nilsson, PTA
• Bonnie Nimmo
• John E Nimmo, PRS
• Nivine El-Refai, DDS, MSD, Inc (Nivine Y. El-Refai, BDS, DDS, MSD, Inc, Gentle Endodontics)
• Matthew Ryan Noel, PT, DPT
• Tonya L Nolan, LSW

• Pharmacist in Medina, OH
• Providers in Medina, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.