Active NPI
Benjamin Matthew Noll, RP
- Pharmacist
- Omaha, NE
National Provider Identifier
1245744291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13692
- Practice address
- 6710 S 167TH St
Omaha, NE 68135-5421 - Phone
- (402) 609-5710
- Fax
- (402) 609-5704
- NPI assigned
- Nov 29, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13692 | NE | Primary |
Addresses
Primary practice location
6710 S 167TH St
Omaha, NE 68135-5421
Mailing address
6710 S 167TH St
Omaha, NE 68135-5421
Phone (402) 609-5710
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 |
|---|---|---|---|
| 13692 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Omaha, NE
- NPI 1518303866
-
- Community/Retail Pharmacy
- Eastvale, CA
- NPI 1770458945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511913600000",
"number": "1245744291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6710 S 167TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681355421",
"telephone_number": "402-609-5710",
"fax_number": "402-609-5704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6710 S 167TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681355421",
"telephone_number": "402-609-5710",
"fax_number": "402-609-5704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLL",
"first_name": "BENJAMIN",
"middle_name": "MATTHEW",
"credential": "RP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-29",
"last_updated": "2017-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "13692",
"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 Nov 29, 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.