Active NPI
Benjamin Ryan Vavra, PHARMD, RPH
- Pharmacist
- Omaha, NE
National Provider Identifier
1528375326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68880
- Practice address
- 4310 Ames Ave
Omaha, NE 68111-2149 - Phone
- (307) 640-1048
- NPI assigned
- Sep 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3175 | WY | |
| Pharmacist | 183500000X | 68880 | CA | Primary |
| Pharmacist | 183500000X | 15014 | NE |
Addresses
Primary practice location
4310 Ames Ave
Omaha, NE 68111-2149
Mailing address
4310 Ames Ave
Omaha, NE 68111-2149
Phone (307) 640-1048
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68880 | CA | MD | Pharmacist |
| 15014 | NE | MD | Pharmacist |
| 3175 | WY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1528375326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 AMES AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681112149",
"telephone_number": "307-640-1048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 AMES AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681112149",
"telephone_number": "307-640-1048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAVRA",
"first_name": "BENJAMIN",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-01",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3175",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68880",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "15014",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.