Individual provider Active NPI

Roberta Jo Carr, RPH

  • Pharmacist
  • Yankton, SD
National Provider Identifier
1750592804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5014 Issued in SD
Practice address
3515 Broadway Ave
Yankton, SD 57078-4917
Phone
(605) 668-3155
Fax
(605) 668-3156
NPI assigned
May 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5014 SD Primary

Addresses

Primary practice location

3515 Broadway Ave
Yankton, SD 57078-4917

Mailing address

1208 W 16TH St
Yankton, SD 57078-1954
Phone (605) 664-0291

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
Registered Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750592804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 W 16TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781954",
            "telephone_number": "605-664-0291",
            "fax_number": "605-668-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784917",
            "telephone_number": "605-668-3155",
            "fax_number": "605-668-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "ROBERTA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "5014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.