Individual provider Active NPI

Tyler Pribnow, OTD, OTR/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1023559622
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1831 Issued in NE
Practice address
10858 W Dodge Rd
Omaha, NE 68154-2609
Phone
(402) 614-7500
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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 1831 NE Primary

Addresses

Primary practice location

10858 W Dodge Rd
Omaha, NE 68154-2609

Mailing address

10858 W Dodge Rd
Omaha, NE 68154-2609

Other practice location 1

17500 Burke St
Omaha, NE 68118-2244
Phone (402) 401-3900 ext. 13609

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

LicenseStateTypeSpecialty
1831NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehab, P.C. PastSince Sep 1, 1999 Accepting new patients

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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1023559622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10858 W DODGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10858 W DODGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542609",
            "telephone_number": "402-614-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17500 Burke St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681182244",
            "country_code": "US",
            "telephone_number": "402-401-3900 x13609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIBNOW",
        "first_name": "TYLER",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1831",
            "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 Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.