Active NPI
James G Dickerson Sr.
- Pharmacist
- Omaha, NE
National Provider Identifier
1073508289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7632
- Practice address
- 601 N 30TH St
Suite 2807
Omaha, NE 68131-2137 - Phone
- (402) 449-4560
- Fax
- (402) 449-4531
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7632 | NE | Primary |
| Pharmacist | 183500000X | 12903 | IA |
Addresses
Primary practice location
601 N 30TH St
Suite 2807
Omaha, NE 68131-2137
Mailing address
15001 S Highway 31
Gretna, NE 68028-6312
Phone (402) 672-4636
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7632 | NE | MD | Dentist |
| 12903 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073508289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15001 S HIGHWAY 31",
"city": "GRETNA",
"state": "NE",
"postal_code": "680286312",
"telephone_number": "402-672-4636",
"fax_number": "402-449-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 N 30TH ST",
"address_2": "SUITE 2807",
"city": "OMAHA",
"state": "NE",
"postal_code": "681312137",
"telephone_number": "402-449-4560",
"fax_number": "402-449-4531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "JAMES",
"middle_name": "G",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "7632",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "12903",
"primary": false
}
],
"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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.