Active NPI
Jackie Rae Myers
- Professional Counselor
- Omaha, NE
National Provider Identifier
1033727037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2463
- Practice address
- 15704 Corby St
Omaha, NE 68116-2042 - Phone
- (402) 350-1107
- NPI assigned
- Jul 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2463 | NE | Primary |
Addresses
Primary practice location
15704 Corby St
Omaha, NE 68116-2042
Mailing address
15704 Corby St
Omaha, NE 68116-2042
Phone (402) 350-1107
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 |
|---|---|---|---|
| 2463 | NE | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1033727037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15704 CORBY ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162042",
"telephone_number": "402-350-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15704 CORBY ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162042",
"telephone_number": "402-350-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "JACKIE",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-16",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "2463",
"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 Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.