Active NPI
Nicholas Vitale, PHARM.D
- Pharmacist
- Shawnee, KS
National Provider Identifier
1912634452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-118079
- Practice address
- 11830 W 75TH St
Shawnee, KS 66214-1366 - Phone
- (913) 433-2359
- NPI assigned
- Aug 4, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-118079 | KS | Primary |
Addresses
Primary practice location
11830 W 75TH St
Shawnee, KS 66214-1366
Mailing address
22016 W 56TH St
Shawnee, KS 66226-7921
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-118079 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
11830 W 75th St
Shawnee, KS 66214
Phone (913) 433-2359
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1912634452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22016 W 56TH ST",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662267921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11830 W 75TH ST",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662141366",
"telephone_number": "913-433-2359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITALE",
"first_name": "NICHOLAS",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-04",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-118079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.