Individual provider Active NPI

Jordan Harra, PHARMD

  • Psychiatric Pharmacist
  • Lincoln, NE
National Provider Identifier
1477249100
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric PharmacistTaxonomy code 1835P1300X
License
6891 Issued in SD
Practice address
420 Victory Park Dr
Lincoln, NE 68510-2484
Phone
(402) 489-3802
NPI assigned
Apr 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Pharmacist 1835P1300X 6891 SD Primary

Addresses

Primary practice location

420 Victory Park Dr
Lincoln, NE 68510-2484

Mailing address

27009 Western Ave
Sioux Falls, SD 57108-8124
Phone (931) 374-5611

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
6891SDMDPsychiatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Vamc CurrentSince Apr 16, 2023 Accepting new patients

Locations

420 Victory Park Dr
Lincoln, NE 68510
Phone (402) 486-7823

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1477249100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27009 WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088124",
            "telephone_number": "931-374-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 VICTORY PARK DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102484",
            "telephone_number": "402-489-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRA",
        "first_name": "JORDAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "SD",
            "license": "6891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.