Active NPI
Jason Edward Haberer, PHARMD
- Pharmacist
- Tulsa, OK
National Provider Identifier
1245824416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17663
- Practice address
- 744 W 9TH St FL 6
Tulsa, OK 74127-9907 - Phone
- (479) 651-7711
- NPI assigned
- Feb 27, 2021
- 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 | 17663 | OK | Primary |
Addresses
Primary practice location
744 W 9TH St FL 6
Tulsa, OK 74127-9907
Mailing address
7431 S 225TH East Ave
Broken Arrow, OK 74014-2421
Other practice location 1
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17663 | Other | OK | OKLAHOMA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 17663 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622419200000",
"number": "1245824416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7431 S 225TH EAST AVE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740142421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 W 9TH ST FL 6",
"city": "TULSA",
"state": "OK",
"postal_code": "741279907",
"telephone_number": "479-651-7711"
}
],
"practiceLocations": [
{
"address_1": "1120 S Utica Ave",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741044012",
"country_code": "US",
"telephone_number": "918-579-7400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HABERER",
"first_name": "JASON",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-27",
"last_updated": "2021-05-31",
"certification_date": "2021-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17663",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA STATE BOARD OF PHARMACY",
"identifier": "17663",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.