Individual provider Active NPI

Ricky Lee Bender

  • Pharmacist
  • Omaha, NE
National Provider Identifier
1053458497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11105 Issued in NE
Practice address
109 S 68TH Ave
Omaha, NE 68132-3309
Phone
(402) 933-5424
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11105 NE Primary

Addresses

Primary practice location

109 S 68TH Ave
Omaha, NE 68132-3309

Mailing address

109 S 68TH Ave
Omaha, NE 68132-3309
Phone (402) 933-5424

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

State licenses

LicenseStateTypeSpecialty
11105NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053458497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S 68TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681323309",
            "telephone_number": "402-933-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S 68TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681323309",
            "telephone_number": "402-933-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "RICKY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "11105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.