Active NPI
Nicole Marie Oberto, PHARM.D.
- Pharmacist
- Belleville, IL
National Provider Identifier
1952406068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2006023298
- Practice address
- 2900 Frank Scott Pkwy W
Suite 920-B
Belleville, IL 62223-5000 - Phone
- (618) 234-7181
- NPI assigned
- Sep 13, 2006
- 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 | 2006023298 | MO | Primary |
Addresses
Primary practice location
2900 Frank Scott Pkwy W
Suite 920-B
Belleville, IL 62223-5000
Mailing address
672 E Vandalia St
Edwardsville, IL 62025-1857
Phone (618) 307-5258
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 |
|---|---|---|---|
| 2006023298 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Copper Bend Pharmacy, Inc | Past | Accepting new patients |
Organizations & group practices 1
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
- Belleville, IL
- NPI 1902918840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952406068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "672 E VANDALIA ST",
"city": "EDWARDSVILLE",
"state": "IL",
"postal_code": "620251857",
"telephone_number": "618-307-5258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W",
"address_2": "SUITE 920-B",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000",
"telephone_number": "618-234-7181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERTO",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2006023298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
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.