Active NPI
Jessica Fluke
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1043760283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3755
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| A4464 | MD | MD | Physical Therapy Assistant |
| TE010877 | PA | MD | Physical 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.