Blake Sommers Nielsen, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

P8325 Issued in ID

Practice address

1611 Blue Lakes Blvd N
Twin Falls, ID 83301-3374

Phone

(208) 736-3321

NPI assigned

Apr 12, 2019

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Pharmacy

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.

• Nevada CVS Pharmacy LLC

  • Pharmacy
  • Elko, NV
  • NPI 1265473169
  NPD (past)

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1801359179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W IDAHO ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013374",
            "telephone_number": "208-736-3321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 W Idaho St",
            "address_purpose": "LOCATION",
            "city": "Elko",
            "state": "NV",
            "postal_code": "898012976",
            "country_code": "US",
            "telephone_number": "775-738-7177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "BLAKE",
        "middle_name": "SOMMERS",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P8325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Horizon Support Services
• New Leaf Behavioral Health
• Joel Newton, DDS
• Travis James Newton, OTRL CLT
• Paul Wendell Nicholson, CRNA
• Brandon Clark Nielsen, O.D.
• Ciera L Nielsen, PHARMD
• Janice Carson Nielsen, LMSW,CSW,CFLE
• Nielson Family Chiropractic Inc
• Chad J Nielson, D.C.

• Pharmacist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.