Individual provider Active NPI

Mallory Maureen Raber, PHARMD

  • Pharmacist
  • Omaha, NE
National Provider Identifier
1972983328
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13212 Issued in NE
Practice address
17810 W Center Rd
Omaha, NE 68130-2308
Phone
(402) 697-4876
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13212 NE Primary

Addresses

Primary practice location

17810 W Center Rd
Omaha, NE 68130-2308

Mailing address

17810 W Center Rd
Omaha, NE 68130-2308
Phone (402) 697-4876

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
13212NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1972983328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17810 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302308",
            "telephone_number": "402-697-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17810 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302308",
            "telephone_number": "402-697-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABER",
        "first_name": "MALLORY",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "13212",
            "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 Jun 1, 2015; 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.