Individual provider Active NPI

Jessica Jo Skradski, RPH, PHARM.D.

  • Pharmacist
  • Omaha, NE
National Provider Identifier
1528077179
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12500 Issued in NE
Practice address
601 N 30TH St
Suite 2807
Omaha, NE 68131-2137
Phone
(402) 449-4560
Fax
(402) 449-4531
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12500 NE Primary

Addresses

Primary practice location

601 N 30TH St
Suite 2807
Omaha, NE 68131-2137

Mailing address

10132 Edward St
La Vista, NE 68128-2500
Phone (402) 326-1945

Other names 1

  • Dr. Jessica Jo Obermeier Former name

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
12500NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1528077179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 EDWARD ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282500",
            "telephone_number": "402-326-1945",
            "fax_number": "402-449-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "address_2": "SUITE 2807",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-4560",
            "fax_number": "402-449-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKRADSKI",
        "first_name": "JESSICA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "RPH, PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "12500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "OBERMEIER",
            "middle_name": "JO",
            "prefix": "DR.",
            "credential": "RPH, PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.