NPIMap

Individual provider Active NPI

Andris Didrichsons, PHARMD

  • Pharmacist
  • Crete, NE
National Provider Identifier
1811523467
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10901 Issued in NE
Practice address
1800 E 29TH St
Crete, NE 68333-3074
Phone
(402) 826-1032
NPI assigned
Mar 16, 2020
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10901 NE Primary

Addresses

Primary practice location

1800 E 29TH St
Crete, NE 68333-3074

Mailing address

4808 O St
Lincoln, NE 68510-1908
Phone (402) 467-1134

Other practice location 1

4808 O St
Lincoln, NE 68510-1908
Phone (402) 467-1134

Other practice location 2

2101 S 11th St
Nebraska City, NE 68410-3481
Phone (402) 874-9093

Other practice location 3

3620 N 6th St
Beatrice, NE 68310-1141
Phone (402) 228-4594

Other practice location 4

2831 Highway 15
Fairbury, NE 68352-1008
Phone (402) 729-3755

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

LicenseStateTypeSpecialty
10901NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. Past Accepting new patients
Nebraska CVS Pharmacy LLC PastSince Mar 1, 2020 Accepting new patients
Walmart Inc. PastSince Apr 3, 2022 Accepting new patients
Walmart Inc. PastSince Apr 3, 2022 Accepting new patients
Walmart Inc. Past Accepting new patients

Organizations & group practices 5

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": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1811523467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 O ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101908",
            "telephone_number": "402-467-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E 29TH ST",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683333074",
            "telephone_number": "402-826-1032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4808 O St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685101908",
            "country_code": "US",
            "telephone_number": "402-467-1134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Nebraska City",
            "state": "NE",
            "postal_code": "684103481",
            "country_code": "US",
            "telephone_number": "402-874-9093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3620 N 6th St",
            "address_purpose": "LOCATION",
            "city": "Beatrice",
            "state": "NE",
            "postal_code": "683101141",
            "country_code": "US",
            "telephone_number": "402-228-4594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2831 Highway 15",
            "address_purpose": "LOCATION",
            "city": "Fairbury",
            "state": "NE",
            "postal_code": "683521008",
            "country_code": "US",
            "telephone_number": "402-729-3755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIDRICHSONS",
        "first_name": "ANDRIS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "10901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.