Active NPI
Jacqueline J Small, PHARMD
- Pharmacist
- Papillion, NE
National Provider Identifier
1003416272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11887
- Practice address
- 11650 S 73Rd St
Papillion, NE 68046-1500 - Phone
- (402) 597-5056
- NPI assigned
- Oct 28, 2020
- Sex
- Female
- 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 | 11887 | NE | Primary |
Addresses
Primary practice location
11650 S 73Rd St
Papillion, NE 68046-1500
Mailing address
4805 Fountain Cir
Papillion, NE 68133-4726
Phone (402) 639-3986
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 |
|---|---|---|---|
| 11887 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1003416272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4805 FOUNTAIN CIR",
"city": "PAPILLION",
"state": "NE",
"postal_code": "681334726",
"telephone_number": "402-639-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11650 S 73RD ST",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680461500",
"telephone_number": "402-597-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALL",
"first_name": "JACQUELINE",
"middle_name": "J",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "11887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.