Active NPI
Gary Fabisiak
- Pharmacist
- Omaha, NE
National Provider Identifier
1609143718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10158
- Practice address
- 13155 W Center Rd
Omaha, NE 68144-3740 - Phone
- (402) 334-9134
- NPI assigned
- Nov 18, 2011
- Last updated
- Nov 18, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10158 | NE | Primary |
Addresses
Primary practice location
13155 W Center Rd
Omaha, NE 68144-3740
Mailing address
21725 Bonanza BLD
Elkhorn, NE 68022
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10158 | NE | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1609143718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21725 BONANZA BLD",
"city": "ELKHORN",
"state": "NE",
"postal_code": "68022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13155 W CENTER RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681443740",
"telephone_number": "402-334-9134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABISIAK",
"first_name": "GARY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-18",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "10158",
"primary": true
}
],
"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 Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.