Individual provider Active NPI

Jennifer Collins, PHARMD

  • Pharmacist
  • La Vista, NE
National Provider Identifier
1366036584
Registry record updated Feb 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12730 Issued in NE
Practice address
6901 S 84TH St
La Vista, NE 68128-2127
Phone
(402) 339-1090
NPI assigned
Feb 28, 2021
Last updated
Feb 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12730 NE Primary

Addresses

Primary practice location

6901 S 84TH St
La Vista, NE 68128-2127

Mailing address

7427 S 198TH St
Gretna, NE 68028-4946
Phone (402) 707-3383

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

LicenseStateTypeSpecialty
12730NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1366036584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7427 S 198TH ST",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680284946",
            "telephone_number": "402-707-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 S 84TH ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282127",
            "telephone_number": "402-339-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JENNIFER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-28",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vista, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.