Nicole Marie Shouse, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

19875-40 Issued in WI

Practice address

1700 Milton Ave
Janesville, WI 53545-0833

Phone

(608) 756-0614

Fax

(608) 756-0634

NPI assigned

Mar 25, 2020

Sex

Female

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.

• Wisconsin CVS Pharmacy LLC

  • Pharmacy
  • Janesville, WI
  • NPI 1194158303
  NPD (past)
• Wisconsin CVS Pharmacy LLC

  • Pharmacy
  • Glendale, WI
  • NPI 1649947573
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1801423116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MILTON AVE UNIT 1",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MILTON AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450833",
            "telephone_number": "608-756-0614",
            "fax_number": "608-756-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUSE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19875-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juili Subodh Shivde, DMD, MS, BDS
• Audrey T Shomos, CD
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC
• Avigya Shrestha, DMD
• Pinak Y Shukla, MD
• Atiya A Siddiqui, MD
• Tehreem Siddiqui, MD
• Zahir M Siddiqui

• Pharmacist in Janesville, WI
• Providers in Janesville, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.