Individual provider Active NPI

Steven James Nylen Jr.

  • Pharmacist
  • Medford, WI
National Provider Identifier
1558960963
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18642-40 Issued in WI
Practice address
1010 N 8TH St
Medford, WI 54451-1278
Phone
(715) 748-9020
NPI assigned
Oct 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18642-40 WI Primary

Addresses

Primary practice location

1010 N 8TH St
Medford, WI 54451-1278

Mailing address

840 Malibu Dr
Medford, WI 54451-1211
Phone (815) 274-2110

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

LicenseStateTypeSpecialty
18642-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1558960963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 MALIBU DR",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511211",
            "telephone_number": "815-274-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 8TH ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511278",
            "telephone_number": "715-748-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLEN",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "18642-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.