Active NPI
Jodi M Fabisiak, RPH
- Pharmacist
- Elkhorn, NE
National Provider Identifier
1508355520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10266
- Practice address
- 1810 N 203Rd St
Elkhorn, NE 68022-2885 - Phone
- (402) 289-0189
- NPI assigned
- May 4, 2018
- 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 | 10266 | NE | Primary |
Addresses
Primary practice location
1810 N 203Rd St
Elkhorn, NE 68022-2885
Mailing address
21725 Bonanza Blvd
Elkhorn, NE 68022-1809
Phone (402) 681-8391
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10266 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525392000000",
"number": "1508355520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21725 BONANZA BLVD",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680221809",
"telephone_number": "402-681-8391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 N 203RD ST",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680222885",
"telephone_number": "402-289-0189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABISIAK",
"first_name": "JODI",
"middle_name": "M",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-04",
"last_updated": "2018-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "10266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.