Active NPI
Judy L. Gonnerman, MA
- Mental Health Counselor
- Lincoln, NE
National Provider Identifier
1003989138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2491
- Practice address
- 1919 S 40TH St Ste 212
Lincoln, NE 68506-5248 - Phone
- (402) 441-9280
- NPI assigned
- Nov 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2491 | NE | Primary |
| Professional Counselor | 101YP2500X | 1353 | NE |
Addresses
Primary practice location
1919 S 40TH St Ste 212
Lincoln, NE 68506-5248
Mailing address
1919 S 40TH St Ste 212
Lincoln, NE 68506-5248
Phone (402) 441-9280
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 339315 | Other | NE | VALUE OPTIONS # |
| 47075636998 | Medicaid | NE | |
| 47075636926 | Medicaid | NE | |
| 84078 | Other | NE | BLUE CROSS & BLUE SHIELD |
| 68506A008 | Other | NE | TRICARE |
| 236670 | Other | NE | MIDLANDS INSURANCE # |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1353 | NE | MD | Physical Therapy Assistant |
| 2491 | NE | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1003989138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 S 40TH ST STE 212",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685065248",
"telephone_number": "402-441-9280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S 40TH ST STE 212",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685065248",
"telephone_number": "402-441-9280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONNERMAN",
"first_name": "JUDY",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "2491",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "1353",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS #",
"identifier": "339315",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47075636998",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47075636926",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "84078",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "68506A008",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS INSURANCE #",
"identifier": "236670",
"state": "NE"
}
],
"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 Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.