Active NPI
Nichole L Keller, PHD
- Pharmacist
- Omaha, NE
National Provider Identifier
1114202603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12964
- Practice address
- 1827 N 103Rd Avenue
Omaha, NE 68114-1149 - Phone
- (402) 594-5060
- NPI assigned
- Oct 15, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12964 | NE | Primary |
| Pharmacist | 183500000X | 20887 | IA |
Addresses
Primary practice location
1827 N 103Rd Avenue
Omaha, NE 68114-1149
Mailing address
1827 N 103Rd Ave
Omaha, NE 68114-1149
Phone (140) 259-4506
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12964 | NE | MD | Mental Health Counselor |
| 20887 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318636800000",
"number": "1114202603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1827 N 103RD AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681141149",
"telephone_number": "140-259-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1827 N 103RD AVENUE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681141149",
"telephone_number": "402-594-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "NICHOLE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-15",
"last_updated": "2011-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "12964",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20887",
"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 Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.