Active NPI
Jamie Susanne Reynolds, PHARM.D.
- Psychiatric Pharmacist
- Omaha, NE
National Provider Identifier
1083310809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 17103
- Practice address
- 4350 Dewey Ave
Omaha, NE 68105-1017 - Phone
- (913) 488-9643
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 17103 | NE | Primary |
Addresses
Primary practice location
4350 Dewey Ave
Omaha, NE 68105-1017
Mailing address
438 S 159TH Ave
Omaha, NE 68118-2133
Phone (913) 488-9643
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 |
|---|---|---|---|
| 17103 | NE | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1083310809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 S 159TH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182133",
"telephone_number": "913-488-9643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 DEWEY AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051017",
"telephone_number": "913-488-9643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "JAMIE",
"middle_name": "SUSANNE",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "NE",
"license": "17103",
"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 Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.