Individual provider Active NPI

Mary Ann Halda

  • Pharmacist
  • Lincoln, NE
National Provider Identifier
1104331495
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13634 Issued in NE
Practice address
3400 N 85TH St
Lincoln, NE 68507-9457
Phone
(402) 466-0095
NPI assigned
Dec 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13634 NE Primary

Addresses

Primary practice location

3400 N 85TH St
Lincoln, NE 68507-9457

Mailing address

9630 Fairbury LN
Lincoln, NE 68516-9437
Phone (515) 564-9776

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
13634NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1104331495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9630 FAIRBURY LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685169437",
            "telephone_number": "515-564-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N 85TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685079457",
            "telephone_number": "402-466-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALDA",
        "first_name": "MARY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "13634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.