Individual provider Active NPI

Nicholas Ryan Schulz, PHARMD

  • Pharmacist
  • Roseville, MN
National Provider Identifier
1568051209
Registry record updated Jan 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
124117 Issued in MN
Practice address
3101 Old Highway 8 Ste 203B
Roseville, MN 55113-1077
Phone
(612) 326-9225
NPI assigned
Jan 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 124117 MN Primary

Addresses

Primary practice location

3101 Old Highway 8 Ste 203B
Roseville, MN 55113-1077

Mailing address

2100 Mohawk Dr
Medina, MN 55340-9514
Phone (763) 486-3585

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
124117MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC CurrentSince May 1, 2023 Accepting new patients
Genoa Healthcare LLC PastSince Jan 24, 2021 Accepting new patients

Locations

3101 Old Highway 8
Ste 203B
Roseville, MN 55113
Phone (612) 326-9225

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610841600000",
    "number": "1568051209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MOHAWK DR",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "553409514",
            "telephone_number": "763-486-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 OLD HIGHWAY 8 STE 203B",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131077",
            "telephone_number": "612-326-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZ",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-17",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2021; 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.