Samuel Burns, LIMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2230 Issued in NE

Practice address

2740 N Clarkson St
Fremont, NE 68025-7703

Phone

(402) 721-0951

Fax

(402) 721-0804

NPI assigned

Apr 23, 2014

Last updated

Dec 30, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connected Group LLCGroup PAC ID 6103320213, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• IA HMO C-SNP
• CO HMO
• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• CO HMO D-SNP
• IA HMO
• CO HMO C-SNP

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

• Connected Group LLC

  dba Everwood Mental Health

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1043911241
  Medicare reassignment Care Compare group NPD
• Healing Tree Counseling

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1265759799
  NPD (past)

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1033539580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 LEAVENWORTH ST.",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022933",
            "telephone_number": "402-614-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257703",
            "telephone_number": "402-721-0951",
            "fax_number": "402-721-0804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Leavenworth St",
            "address_2": "MSHS",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681022933",
            "country_code": "US",
            "telephone_number": "402-614-4870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "SAMUEL",
        "credential": "LIMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025851800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMHP LICENSE",
            "identifier": "2230",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany N Burbach, APRN
• Genie Jean Burgmeyer
• Jedidiah Michael Burkey, O.D.
• Michalla Burmester
• Hannah Burns
• Lilly Bushlow
• Kael Gerhardt Busing, MSC, PLMHP
• Maria Z Cacho, DDS
• Richard Earl Callaway, D.D.S.
• Josielyn Mallari Camacho

• Clinical Social Worker in Fremont, NE
• Providers in Fremont, NE by specialty
• Clinical Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.