Active NPI
Casey Logan Oberste, PHARMD, RPH
- Pharmacist
- Broken Arrow, OK
National Provider Identifier
1982200507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18775
- Practice address
- 3900 E Hillside Dr
Broken Arrow, OK 74014-6713 - Phone
- (918) 355-1076
- NPI assigned
- Dec 9, 2020
- 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 | 18775 | OK | Primary |
Addresses
Primary practice location
3900 E Hillside Dr
Broken Arrow, OK 74014-6713
Mailing address
220 W 126TH St S
Jenks, OK 74037-5202
Phone (607) 372-9039
Other practice location 1
2351 N 9th St
Broken Arrow, OK 74012-2850
Phone (918) 355-1293
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18775 | Other | OK | OKLAHOMA BOARD OF PHARMACY |
Other names 1
- Casey Logan Mullins
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18775 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients | |
| Oklahoma CVS Pharmacy LLC | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 4
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.
-
dba WalMart Pharmacy 10-4637
- Community/Retail Pharmacy
- Broken Arrow, OK
- NPI 1699905901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651968000000",
"number": "1982200507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W 126TH ST S",
"city": "JENKS",
"state": "OK",
"postal_code": "740375202",
"telephone_number": "607-372-9039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 E HILLSIDE DR",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740146713",
"telephone_number": "918-355-1076"
}
],
"practiceLocations": [
{
"address_1": "2351 N 9th St",
"address_purpose": "LOCATION",
"city": "Broken Arrow",
"state": "OK",
"postal_code": "740122850",
"country_code": "US",
"telephone_number": "918-355-1293",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OBERSTE",
"first_name": "CASEY",
"middle_name": "LOGAN",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-09",
"last_updated": "2022-05-08",
"certification_date": "2022-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "18775",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA BOARD OF PHARMACY",
"identifier": "18775",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CASEY",
"last_name": "MULLINS",
"middle_name": "LOGAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.