Active NPI
James F Andreesen
- Pharmacist
- Ord, NE
National Provider Identifier
1619579489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8653
- Practice address
- 125 S 16TH St
Ord, NE 68862-1464 - Phone
- (308) 728-3295
- Fax
- (308) 728-3296
- NPI assigned
- Nov 16, 2020
- Last updated
- Nov 16, 2020
- 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 | 8653 | NE | Primary |
Addresses
Primary practice location
125 S 16TH St
Ord, NE 68862-1464
Mailing address
125 S 16TH St
Ord, NE 68862-1464
Phone (308) 728-3295
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 |
|---|---|---|---|
| 8653 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Life Health Services Inc | Pharmacist | Past | Accepting new patients |
| Good Life Health Services Inc | Pharmacist | 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.
-
dba Good Life Pharmacy
- Pharmacy
- Loup City, NE
- NPI 1912091091
Pharmacist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1619579489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 S 16TH ST",
"city": "ORD",
"state": "NE",
"postal_code": "688621464",
"telephone_number": "308-728-3295",
"fax_number": "308-728-3296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 S 16TH ST",
"city": "ORD",
"state": "NE",
"postal_code": "688621464",
"telephone_number": "308-728-3295",
"fax_number": "308-728-3296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDREESEN",
"first_name": "JAMES",
"middle_name": "F",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "8653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ord, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.