Active NPI
Justin Matthew Frazer, PHARM.D.
- Pharmacotherapy Pharmacist
- Omaha, NE
National Provider Identifier
1194789446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 11900
- Practice address
- 4101 Woolworth Ave
Omaha, NE 68105-1850 - Phone
- (402) 995-5206
- NPI assigned
- Apr 13, 2006
- 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 | 11900 | NE | |
| Pharmacotherapy Pharmacist | 1835P1200X | 11900 | NE | Primary |
Addresses
Primary practice location
4101 Woolworth Ave
Omaha, NE 68105-1850
Mailing address
4101 Woolworth Ave
Omaha, NE 68105-1850
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 |
|---|---|---|---|
| 11900 | NE | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1194789446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZER",
"first_name": "JUSTIN",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "11900",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NE",
"license": "11900",
"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 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.