Individual provider Active NPI

Nicholas Simon, PHARMD

  • Pharmacist
  • Deerfield, IL
National Provider Identifier
1992324156
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051302410 Issued in IL
Practice address
1525 Lake Cook Rd Apt 231
Deerfield, IL 60015-5297
Phone
(847) 922-8535
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051302410 IL Primary

Addresses

Primary practice location

1525 Lake Cook Rd Apt 231
Deerfield, IL 60015-5297

Mailing address

1525 Lake Cook Rd Apt 231
Deerfield, IL 60015-5297

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

LicenseStateTypeSpecialty
051302410ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Hooves Pharmacy Incorporated CurrentSince Mar 1, 2023 Accepting new patients
Happy Hooves Pharmacy Incorporated CurrentSince Jul 23, 2023 Accepting new patients

Locations

1408 Sidney Baker St
Kerrville, TX 78028
Phone (830) 999-6337

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1992324156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LAKE COOK RD APT 231",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LAKE COOK RD APT 231",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155297",
            "telephone_number": "847-922-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051302410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.