Active NPI
Annette Lynn Dickman, PHARM D
- Pharmacist
- La Vista, NE
National Provider Identifier
1669986436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11864
- Practice address
- 9460 Giles Rd
La Vista, NE 68128-3064 - Phone
- (402) 513-4214
- Fax
- (402) 513-4208
- NPI assigned
- Nov 30, 2017
- 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 | 11864 | NE | Primary |
Addresses
Primary practice location
9460 Giles Rd
La Vista, NE 68128-3064
Mailing address
9460 Giles Rd
La Vista, NE 68128-3064
Phone (402) 513-4214
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11864 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- La Vista, NE
- NPI 1376977223
-
- Community/Retail Pharmacy
- Eastvale, CA
- NPI 1770458945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1669986436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9460 GILES RD",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681283064",
"telephone_number": "402-513-4214",
"fax_number": "402-513-4208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9460 GILES RD",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681283064",
"telephone_number": "402-513-4214",
"fax_number": "402-513-4208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKMAN",
"first_name": "ANNETTE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "11864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vista, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.