DR. MICHAEL J BRODERSEN (NPI# 1295029155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295029155 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J BRODERSEN |
| Credential | PHARM.D. |
| Practice Address |
17201 Wright St Ste 203 Omaha NE 68130-2042 |
| Practice Telephone | 4026915102 |
| Mailing Telephone | 4026915102 |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2014-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 12870 | NE | Pharmacy Service Providers |
| Street Address |
17201 WRIGHT ST STE 203 |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-2042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365249 | Kenneth Fuchtman | Pharmacist | 4969 S 174th Ave, Omaha, NE 68135-3463 | 2020-10-30 |
| 1073120796 | Derek Eugene Popken | Pharmacist | Nebraska Medicine, 987400 Nebraska Medical Center, Omaha, NE 68198-7400 | 2020-09-27 |
| 1003441874 | Riddhi Prakashbhai | Pharmacist | 4578 S 60th St, Omaha, NE 68117-1217 | 2020-03-11 |
| 1083249569 | Katrina Johanna Keebler | Pharmacist | 8315 W Center Rd, Omaha, NE 68124-3111 | 2020-03-05 |
| 1578103644 | Nathan L Suck | Pharmacist | 2115 S 61st St, Omaha, NE 68106-2129 | 2020-01-07 |
| 1427696152 | Suzanne Dee Anderson | Pharmacist | 16101 Evans St Ste 101, Omaha, NE 68116-6447 | 2019-12-12 |
| 1073078713 | Brooke Dee Hayes | Pharmacist | 10802 Farnam Dr Ste 100, Omaha, NE 68154-3200 | 2019-02-06 |
| 1124596812 | Neveen Eed | Pharmacist | 4216 N 146th Plz Apt 307, Omaha, NE 68116-4397 | 2018-11-11 |
| 1619450293 | James Robert Mcclane | Pharmacist | 17461 O St, Omaha, NE 68135-3445 | 2018-09-10 |
| 1578054482 | Michael G Heskin | Pharmacist | 4509 S 143rd St Ste 4, Omaha, NE 68137-4521 | 2018-05-25 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.