Active NPI
Rebecca Max
- Pharmacist
- Council Bluffs, IA
National Provider Identifier
1346696010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21728
- Practice address
- 2803 E Kanesville Blvd
Council Bluffs, IA 51503-1004 - Phone
- (712) 325-0987
- Fax
- (847) 396-2530
- NPI assigned
- May 11, 2016
- Sex
- Female
- 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 | 21728 | IA | Primary |
Addresses
Primary practice location
2803 E Kanesville Blvd
Council Bluffs, IA 51503-1004
Mailing address
2803 E Kanesville Blvd
Council Bluffs, IA 51503-1004
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 |
|---|---|---|---|
| 21728 | IA | MD | Family Medicine Physician |
Interoperability endpoints
- rebeccamax@phs.ssdirect.aprima.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1346696010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2803 E KANESVILLE BLVD",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2803 E KANESVILLE BLVD",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031004",
"telephone_number": "712-325-0987",
"fax_number": "847-396-2530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAX",
"first_name": "REBECCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-11",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.