Active NPI
Stacey Marie Bosse, PHARMD
- Pharmacist
- Omaha, NE
National Provider Identifier
1730994229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15391
- Practice address
- 17500 Burke St
Omaha, NE 68118-2244 - Phone
- (402) 401-3579
- NPI assigned
- Feb 11, 2025
- Last updated
- Feb 11, 2025
- 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 | 15391 | NE | Primary |
Addresses
Primary practice location
17500 Burke St
Omaha, NE 68118-2244
Mailing address
18803 Taylor Cir
Elkhorn, NE 68022-3819
Phone (402) 360-2115
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 |
|---|---|---|---|
| 15391 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1730994229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18803 TAYLOR CIR",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680223819",
"telephone_number": "402-360-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17500 BURKE ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182244",
"telephone_number": "402-401-3579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSE",
"first_name": "STACEY",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-11",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "15391",
"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 Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.