Individual provider Active NPI

Nicholas Mitchell Dimarco

  • Pharmacist
  • Crown Point, IN
National Provider Identifier
1669068979
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26026023A Issued in IN
Practice address
8383 Doubletree Dr S
Crown Point, IN 46307-9358
Phone
(219) 545-1063
NPI assigned
Dec 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 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 26026023A IN Primary

Addresses

Primary practice location

8383 Doubletree Dr S
Crown Point, IN 46307-9358

Mailing address

8383 Doubletree Dr S
Crown Point, IN 46307-9358

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
26026023AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1669068979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8383 DOUBLETREE DR S",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 DOUBLETREE DR S",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079358",
            "telephone_number": "219-545-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "NICHOLAS",
        "middle_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026023A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.