Individual provider Active NPI

Karl Stephen Villaluz, RPH

  • Community/Retail Pharmacy
  • North Las Vegas, NV
National Provider Identifier
1740973908
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
23374 Issued in NV
Practice address
1825 Civic Center Dr
North Las Vegas, NV 89030-7113
Phone
(312) 545-3805
NPI assigned
Jun 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 23374 NV Primary
Community/Retail Pharmacy 3336C0003X P10621 ID

Addresses

Primary practice location

1825 Civic Center Dr
North Las Vegas, NV 89030-7113

Mailing address

1825 Civic Center Dr
North Las Vegas, NV 89030-7113
Phone (312) 545-3805

Other practice location 1

1570 E Fairview Ave
Meridian, ID 83642-1821
Phone (208) 888-0034

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
P10621IDMDCommunity/Retail Pharmacy
23374NVMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Pharmacy, LLC Community/Retail Pharmacy Current Accepting new patients
Family Medical Pharmacy, LLC Current Accepting new patients
Walgreen Co Community/Retail Pharmacy PastSince Jun 1, 2023 Accepting new patients
Walgreen Co Community/Retail Pharmacy PastSince Jun 1, 2023 Accepting new patients

Locations

1825 Civic Center Dr
North Las Vegas, NV 89030
Phone (312) 545-3805

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706918400000",
    "number": "1740973908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307113",
            "telephone_number": "312-545-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890307113",
            "telephone_number": "312-545-3805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1570 E Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836421821",
            "country_code": "US",
            "telephone_number": "208-888-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALUZ",
        "first_name": "KARL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "23374",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "P10621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.