Active NPI
Alisha Lee Ettleman, OTR/L
- Occupational Therapist
- Nebraska City, NE
National Provider Identifier
1003007436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 769
- Practice address
- 1314 3Rd Ave
Nebraska City, NE 68410-1930 - Phone
- (402) 873-8918
- NPI assigned
- Aug 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 769 | NE | Primary |
Addresses
Primary practice location
1314 3Rd Ave
Nebraska City, NE 68410-1930
Mailing address
1314 3Rd Ave
Nebraska City, NE 68410-1930
Phone (402) 873-8918
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 769 | NE | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1003007436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 3RD AVE",
"city": "NEBRASKA CITY",
"state": "NE",
"postal_code": "684101930",
"telephone_number": "402-873-8918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 3RD AVE",
"city": "NEBRASKA CITY",
"state": "NE",
"postal_code": "684101930",
"telephone_number": "402-873-8918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETTLEMAN",
"first_name": "ALISHA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nebraska City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.