Nudak Ventures LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

264296 Issued in MN

Legal business name

NUDAK VENTURES LLC

Practice address

1106 Hobart Street
Hawley, MN 56549-0626

Phone

(218) 486-4663

Fax

(218) 486-5327

NPI assigned

Jan 3, 2014

Organization subpart

No

Name

Lori Willis

Title

Acquisitions Manager

Phone

(515) 280-2927

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Jerry'S Enterprises, Inc

  • Community/Retail Pharmacy
  • North Branch, MN
  • NPI 1265084792

  O20131106000139

  Same enrollment
• Nudak Ventures LLC

  • Community/Retail Pharmacy
  • Paynesville, MN
  • NPI 1639251424

  O20131106000139

  Same enrollment
• Nudak Ventures LLC

  • Community/Retail Pharmacy
  • Montezuma, IA
  • NPI 1447778253

  O20131106000139

  Same enrollment

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

• NuCara Pharmacy #38 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 15, 2026.

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1689095952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "CONRAD",
            "state": "IA",
            "postal_code": "506210640",
            "telephone_number": "641-366-3440",
            "fax_number": "641-366-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 HOBART STREET",
            "city": "HAWLEY",
            "state": "MN",
            "postal_code": "565490626",
            "telephone_number": "218-486-4663",
            "fax_number": "218-486-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDAK VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACQUISITIONS MANAGER",
        "authorized_official_telephone_number": "515-280-2927"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "264296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuCara Pharmacy #38",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NuCara Pharmacy #38",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mental Health Matters Psychiatry PLLC
• Jacky Eileen Mergner, OTRL
• Emily Ann Miller, D.M.D.
• Mobilityplus Rehabilitation, LTD
• Sheila Marie Nelson
• Katlyn Olson, PT, DPT
• Neha Patel, DDS
• Devon Pekas, MD, MS
• Nicole M. Perman, CCC-SLP
• Nicole Jean Reardon, D.D.S.

• All providers in Hawley, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.