Mary Nikoula

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1-120395 Issued in KS

Practice address

2014 W 21St St N
Wichita, KS 67203-2107

Phone

(316) 821-9678

NPI assigned

Nov 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kansas CVS Pharmacy LLC

  • Pharmacy
  • Wichita, KS
  • NPI 1528404274
  NPD (past)
• Kansas CVS Pharmacy, L.L.C

  • Pharmacy
  • Gardner, KS
  • NPI 1962914838
  NPD (past)

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1649095183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 S ROCKY CREEK DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672302800",
            "telephone_number": "316-990-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 W 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032107",
            "telephone_number": "316-821-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOULA",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "1-120395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Rose Niemer, ATC
• Kaytlin Nierman
• Avery Margaret Niernberger, LPC
• Gerald E Niernberger, DO
• Nikol Flynn, DDS, LLC
• Norma Dale Niles-Moore, DDS
• Aaron Nilhas, MD
• Sara Danielle Nilhas, DNP
• Mary C Nilles, ARNP
• Kari Meagan Nilsen, PHD

• Community/Retail Pharmacy in Wichita, KS
• Providers in Wichita, KS by specialty
• Community/Retail Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.