Active NPI
Nickalaus David Bryce, PHARMD
- Pharmacist
- Willcox, AZ
National Provider Identifier
1578680922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15445
- Practice address
- 650 N Bisbee Ave
Willcox, AZ 85643-1437 - Phone
- (520) 384-4612
- NPI assigned
- Mar 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15445 | AZ | Primary |
Addresses
Primary practice location
650 N Bisbee Ave
Willcox, AZ 85643-1437
Mailing address
490 W Smith St
Saint David, AZ 85630-6133
Phone (520) 720-2629
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15445 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| N & R Bryce Enterprises LLC | Current | Accepting new patients | |
| N & R Bryce Enterprises LLC | Current | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba White Mountain Pharmacy
- Community/Retail Pharmacy
- Show Low, AZ
- NPI 1386168250
-
dba White Mountain Pharmacy 2
- Community/Retail Pharmacy
- Overgaard, AZ
- NPI 1417513904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578680922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 W SMITH ST",
"city": "SAINT DAVID",
"state": "AZ",
"postal_code": "856306133",
"telephone_number": "520-720-2629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 N BISBEE AVE",
"city": "WILLCOX",
"state": "AZ",
"postal_code": "856431437",
"telephone_number": "520-384-4612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYCE",
"first_name": "NICKALAUS",
"middle_name": "DAVID",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "15445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willcox, AZ
- American Indian Prevention Coalition (NDNS4Wellness)
- Arizona Counseling & Treatment Servcies
- Mary Balderston
- Amanda Dawn Bennett, FNP-C
- Dale Todd Bennett, M.ED
- Jeffery Burl Bushman, D.O.
- Abby F Camisa, OTD
- Charles WM. Leighton Jr Hospice, Inc.
- Child & Family Resources, Inc.
- Chiricahua Community Health Centers, Inc. (Willcox Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.