Active NPI
Christopher Mark Nickele, PHARMD
- Pharmacist
- Terre Haute, IN
National Provider Identifier
1992300842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26022205A
- Practice address
- 2440 Wabash Ave
Terre Haute, IN 47807-3310 - Phone
- (812) 235-4322
- Fax
- (812) 235-1562
- NPI assigned
- Nov 30, 2020
- 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 | 26022205A | IN | Primary |
Addresses
Primary practice location
2440 Wabash Ave
Terre Haute, IN 47807-3310
Mailing address
2440 Wabash Ave
Terre Haute, IN 47807-3310
Phone (812) 235-4322
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 |
|---|---|---|---|
| 26022205A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Terre Haute, IN
- NPI 1558302455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1992300842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 WABASH AVE",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478073310",
"telephone_number": "812-235-4322",
"fax_number": "812-235-1562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 WABASH AVE",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478073310",
"telephone_number": "812-235-4322",
"fax_number": "812-235-1562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKELE",
"first_name": "CHRISTOPHER",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "IN",
"license": "26022205A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.