Individual provider Active NPI

Brooke M Poppe, OTD, OTR/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1013528165
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2447 Issued in NE
Practice address
17500 Burke St
Omaha, NE 68118-2244
Phone
(402) 401-3900
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2447 NE Primary

Addresses

Primary practice location

17500 Burke St
Omaha, NE 68118-2244

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (402) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230725001994 AR Practitioner - Occupational Therapist in Private Practice 4486015393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fusion Therapy Center LLCGroup PAC ID 3173981776, 15 clinicians

Practice addresses (Care Compare)

3201 SW Regency Pkwy
Suite 5
Bentonville, AR 72712-7488
Phone (479) 252-3321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2447NEMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Therapy Center, LLC Occupational Therapist CurrentSince Jul 11, 2023 Accepting new patients

Locations

3108 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

3201 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1013528165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 BURKE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182244",
            "telephone_number": "402-401-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPE",
        "first_name": "BROOKE",
        "middle_name": "M",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.