Individual provider Active NPI

Ward William Wageman, RP

  • Pharmacist
  • Fremont, NE
National Provider Identifier
1255415287
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10221 Issued in NE
Practice address
322 E 22ND
Fremont, NE 68025-2608
Phone
(402) 721-5433
Fax
(402) 721-5444
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10221 NE Primary

Addresses

Primary practice location

322 E 22ND
Fremont, NE 68025-2608

Mailing address

1866 Gaeth Ave
Fremont, NE 68025

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
10221NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1255415287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 GAETH AVE",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "68025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 E 22ND",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252608",
            "telephone_number": "402-721-5433",
            "fax_number": "402-721-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGEMAN",
        "first_name": "WARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "RP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "10221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.