Individual provider Active NPI

Jessica Fluke

  • Physical Therapy Assistant
  • Omaha, NE
National Provider Identifier
1043760283
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3755 Issued in SC
Practice address
13609 California St Ste 200
Omaha, NE 68154-5245
Phone
(402) 891-1118
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A4464 MD
Physical Therapy Assistant 225200000X 2640 OK
Physical Therapy Assistant 225200000X TE010877 PA
Physical Therapy Assistant 225200000X 3755 SC Primary

Addresses

Primary practice location

13609 California St Ste 200
Omaha, NE 68154-5245

Mailing address

522 Cherry St
Martinsburg, PA 16662-1049
Phone (814) 599-0680

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
A4464MDMDPhysical Therapy Assistant
TE010877PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1043760283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 CHERRY ST",
            "city": "MARTINSBURG",
            "state": "PA",
            "postal_code": "166621049",
            "telephone_number": "814-599-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13609 CALIFORNIA ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545245",
            "telephone_number": "402-891-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUKE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4464",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2640",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE010877",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3755",
            "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 Mar 18, 2019; 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.