Active NPI
Samantha Elyse Kenik, PHARMD
- Pharmacist
- Bellevue, NE
National Provider Identifier
1467093021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15383
- Practice address
- 3308 Samson Way Ste 106
Bellevue, NE 68123-3235 - Phone
- (402) 291-5076
- NPI assigned
- Oct 4, 2019
- 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 | 15383 | NE | Primary |
Addresses
Primary practice location
3308 Samson Way Ste 106
Bellevue, NE 68123-3235
Mailing address
1710 S 58TH St
Omaha, NE 68106-2224
Phone (402) 490-7859
Other practice location 1
8613 N 30th St
Omaha, NE 68112-1852
Phone (402) 451-2125
Other practice location 2
7710 Mercy Rd Ste 110
Omaha, NE 68124-2346
Phone (402) 398-6781
Other practice location 3
16909 Lakeside Hills Ct Ste 107
Omaha, NE 68130-4661
Phone (402) 758-5006
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 |
|---|---|---|---|
| 15383 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570147200000",
"number": "1467093021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 S 58TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681062224",
"telephone_number": "402-490-7859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3308 SAMSON WAY STE 106",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "681233235",
"telephone_number": "402-291-5076"
}
],
"practiceLocations": [
{
"address_1": "8613 N 30th St",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681121852",
"country_code": "US",
"telephone_number": "402-451-2125",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7710 Mercy Rd Ste 110",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681242346",
"country_code": "US",
"telephone_number": "402-398-6781",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16909 Lakeside Hills Ct Ste 107",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681304661",
"country_code": "US",
"telephone_number": "402-758-5006",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENIK",
"first_name": "SAMANTHA",
"middle_name": "ELYSE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-04",
"last_updated": "2019-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "15383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.