Active NPI
Nicholas James Jeffries, PA-C
- Physician Assistant
- Lincoln, NE
National Provider Identifier
1033845888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2789
- Practice address
- 7701 Preserve LN
Lincoln, NE 68516-4511 - Phone
- (402) 488-6969
- Fax
- (402) 488-6911
- NPI assigned
- Jul 25, 2022
- Last updated
- Jul 27, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2789 | NE | Primary |
| Dermatology Physician | 207N00000X | 2789 | NE |
Addresses
Primary practice location
7701 Preserve LN
Lincoln, NE 68516-4511
Mailing address
7701 Preserve LN
Lincoln, NE 68516-4511
Phone (402) 488-6969
Other practice location 1
4508 38th St Ste 210
Columbus, NE 68601-1668
Phone (402) 488-6969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2789 | NE | MD | Mental Health Counselor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dermatology Physician
- Lincoln, NE
- NPI 1073679940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1033845888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 PRESERVE LN",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164511",
"telephone_number": "402-488-6969",
"fax_number": "402-488-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 PRESERVE LN",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164511",
"telephone_number": "402-488-6969",
"fax_number": "402-488-6911"
}
],
"practiceLocations": [
{
"address_1": "4508 38th St Ste 210",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "NE",
"postal_code": "686011668",
"country_code": "US",
"telephone_number": "402-488-6969",
"fax_number": "420-488-6911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEFFRIES",
"first_name": "NICHOLAS",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-25",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "2789",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NE",
"license": "2789",
"primary": false
}
],
"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 Jul 27, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.