Active NPI
Jason Sibson, LP
- Clinical Psychologist
- Lincoln, NE
National Provider Identifier
1003237090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 911
- Practice address
- 3801 Union Dr
Suite 206
Lincoln, NE 68516-6652 - Phone
- (402) 489-2218
- NPI assigned
- Dec 18, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2013043796 | MO | |
| Clinical Psychologist | 103TC0700X | 911 | NE | Primary |
Addresses
Primary practice location
3801 Union Dr
Suite 206
Lincoln, NE 68516-6652
Mailing address
601 R St
Apt 619
Lincoln, NE 68508-1334
Phone (402) 990-2429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2022 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013043796 | MO | MD | Mental Health Counselor |
| 566 | SD | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1003237090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 R ST",
"address_2": "APT 619",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685081334",
"telephone_number": "402-990-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 UNION DR",
"address_2": "SUITE 206",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685166652",
"telephone_number": "402-489-2218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIBSON",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-18",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MO",
"license": "2013043796",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.