Active NPI
Lance Elliot Etmund, OTD, OTR/L
- Occupational Therapist
- Lincoln, NE
National Provider Identifier
1023386034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1539
- Practice address
- 6101 Normal Blvd
Lincoln, NE 68506-2767 - Phone
- (402) 489-7175
- NPI assigned
- Dec 5, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1539 | NE | Primary |
Addresses
Primary practice location
6101 Normal Blvd
Lincoln, NE 68506-2767
Mailing address
2924 Channel Dr
Lincoln, NE 68516-4985
Phone (402) 416-7339
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 |
|---|---|---|---|
| 1539 | NE | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1023386034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2924 CHANNEL DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164985",
"telephone_number": "402-416-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 NORMAL BLVD",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685062767",
"telephone_number": "402-489-7175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETMUND",
"first_name": "LANCE",
"middle_name": "ELLIOT",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1539",
"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 Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.