MR. TERRY DALE KERMOADE (NPI# 1780804112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780804112 |
| Entity Type | Individual |
| Full Name | MR. TERRY DALE KERMOADE |
| Credential | R.PH. |
| Practice Address |
520 East 10th Street Superior NE 68978 |
| Mailing Address |
1313 N Kansas St Superior NE 68978-1035 |
| Practice Telephone | 4028794555 |
| Mailing Telephone | 4028793281 |
| Mailing Fax Number | 4028794924 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 8694 | NE | Pharmacy Service Providers |
| Street Address |
520 EAST 10TH STREET |
| City | SUPERIOR |
| State | NE |
| Zip Code | 68978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780776583 | South Central Behavioral Services | Clinic/Center | 520 East 10th Street, Broadstone Memorial Hospital, Superior, NE 68978 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144475740 | Superior Vision PC | Eyewear Supplier (Equipment, not the service) | 358 Central Ave, Superior, NE 68978 | 2008-11-24 |
| 1427234160 | Elinor Lynn Wilton | Speech-Language Pathologist | 4034 Road C, Superior, NE 68978 | 2008-01-11 |
| 1780720904 | Sharon Greenwood | Counselor | 344 North Dakota, Superior, NE 68978 | 2007-01-29 |
| 1033288097 | Peggy Ann Meyer | Counselor | 520 E 10th St, Superior, NE 68978 | 2006-11-06 |
| 1013024215 | Steve Abe Fox | Nurse Anesthetist, Certified Registered | 1324 Montana St, Superior, NE 68978-1038 | 2006-08-24 |
| 1790777936 | Timothy Blecha | Specialist | 525 E 11th St, Superior, NE 68978-1101 | 2005-08-15 |
| 1568756609 | Alisha Fangmeyer | Nurse Practitioner | 525 E 11th St, Superior, NE 68978-1101 | 2011-06-07 |
| 1245552140 | Matthew Gatlin | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2010-02-18 |
| 1073590626 | Brodstone Memorial Hospital | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| 1578540126 | Robert G Leibel | Family Medicine | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| Find all providers in zip 68978 | ||||
| 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 |
|---|---|---|---|---|
| 1255990354 | Kenzie Hohman | Pharmacist | 3500 Tower Ave Ste B, Superior, WI 54880-4685 | 2019-06-12 |
| 1144720319 | Michael Joseph Hillmeyer | Pharmacist | 3500 Tower Ave Ste C, Superior, WI 54880-4685 | 2018-02-14 |
| 1548635659 | Christopher Perkins | Pharmacist | 1995 E Coalton Rd Apt 4-101, Superior, CO 80027-4465 | 2015-12-01 |
| 1831521822 | Susan Jane Seward | Pharmacist | 2031 Dailey Ln, Superior, CO 80027-8106 | 2013-08-01 |
| 1326304981 | Jennifer J. Ellison | Pharmacist | 3015 Tower Ave, Superior, WI 54880-5324 | 2012-04-09 |
| 1538435078 | Renee Marie Toner | Pharmacist | 1601 Coalton Road, Superior, CO 80027 | 2012-03-29 |
| 1083981187 | Cara Bufkin | Pharmacist | 773 Maroon Peak Cir, Superior, CO 80027-6103 | 2011-11-17 |
| 1932419470 | Mi-sook Lee | Pharmacist | 2300 Andrew Dr, Superior, CO 80027 | 2010-10-18 |
| 1821309758 | Gary Tibbett Woodson | Pharmacist | 22 Lozeau Ln, Superior, MT 59872-9622 | 2010-06-25 |
| 1396068490 | Richard Donald Moe | Pharmacist | 2631 Tower Ave, Superior, WI 54880-4846 | 2010-03-04 |
| Find all providers in SUPERIOR | ||||
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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.