NPIMap

Organization Active NPI

Inspiring Change LLC

  • Counselor
  • Blair, NE
National Provider Identifier
1023504164
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
INSPIRING CHANGE LLC
Practice address
128 S 17TH St
Blair, NE 68008-2004
Phone
(402) 304-9229
NPI assigned
Jul 1, 2018
Last updated
Oct 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Authorized official

Name
Amy Douglas, PLMHPNPI 1942795125
Title
Owner
Phone
(402) 304-9229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

128 S 17TH St
Blair, NE 68008-2004

Mailing address

128 S 17TH St
Blair, NE 68008-2004
Phone (402) 304-9229

Other practice location 1

511 N D St
Fremont, NE 68025-5051
Phone (402) 304-9229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240104000770 NE Part B Supplier - Clinic/Group Practice 6305297367 Receives reassigned benefits from 1 practitioner
Practice locations: Blair, NE

National Provider Directory

National Provider Directory

Locations

128 S 17th St
Blair, NE 68008
Phone (402) 304-9229

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1530403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1023504164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 S 17TH ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680082004",
            "telephone_number": "402-304-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S 17TH ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680082004",
            "telephone_number": "402-304-9229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 N D St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "NE",
            "postal_code": "680255051",
            "country_code": "US",
            "telephone_number": "402-304-9229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INSPIRING CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-01",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-304-9229",
        "authorized_official_credential": "PLMHP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.