Nutrishare, LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PHA442630 Issued in CA

Legal business name

NUTRISHARE, LLC

Practice address

9850 Kent St
Elk Grove, CA 95624-9483

Phone

(916) 685-5034

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Austin Pulsipher

Title

President

Phone

(916) 478-7811

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Nutrishare, LLC

  • Home Infusion Therapy Pharmacy
  • Louisville, KY
  • NPI 1609908284

  1951429174

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Nutrishare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Nutrishare, LLC

  • Home Infusion Therapy Pharmacy
  • Phoenix, AZ
  • NPI 1003796889
  NPD tax ID
• Nutrishare, LLC

  • Home Infusion Therapy Pharmacy
  • Louisville, KY
  • NPI 1609908284
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal Wilkinson, PHARMD

  • Pharmacist
  • Elk Grove, CA
  • NPI 1760273874
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1619084829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 KENT ST",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249483",
            "telephone_number": "916-685-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 KENT ST",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249483",
            "telephone_number": "916-685-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRISHARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "PULSIPHER",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-478-7811"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "CA",
            "license": "PHA442630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA442630",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY (STERILE)",
            "identifier": "LSC101704",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0534126",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "PHY58256",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pharmacist@nutrishare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9850 Kent St",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956249483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Jane Novak
• Gregg D Nulton, M.D.
• Lauren Elaine Nunez-Shaw
• Brayan Nunez
• Mohammed Tuha Nure
• Chibuikem Victor Nwani, REGISTERED NURSE
• Elizabeth Tolulope Nwani
• Theresa A Nwaoha-Ezekwo
• Dennis Nyaigoti
• Alexander Nyamadzawo

• Home Infusion Therapy Pharmacy in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Home Infusion Therapy Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.