Connor B Chambers, PT
Individual provider Active NPI Physical Therapist · Lincoln, NE
NPI 1043941735 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1043941735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4368 (NE)
- Practice address
- 6101 Village Dr Ste 100
Lincoln, NE 68516-5830 - Phone
- (402) 420-2626
- NPI assigned
- Jun 22, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Creighton University
Practice addresses (Care Compare)
17055 Frances St
Suite 100
Omaha, NE 68130-4655
Phone (402) 280-3555
3006 Webster St
Omaha, NE 68178-2027
Phone (402) 280-3555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220627003207 | NE | Practitioner - Physical Therapist in Private Practice | 0345629044 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4368 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creighton University | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4368 | NE | Yes |
Addresses
Primary practice location
6101 Village Dr Ste 100
Lincoln, NE 68516-5830
Mailing address
1651 N 86TH St Ste 100
Lincoln, NE 68505-3719
Phone (402) 484-7117
NPI Registry JSON
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655942400000",
"number": "1043941735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 N 86TH ST STE 100",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685053719",
"telephone_number": "402-484-7117",
"fax_number": "402-484-7118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 VILLAGE DR STE 100",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685165830",
"telephone_number": "402-420-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERS",
"first_name": "CONNOR",
"middle_name": "B",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "4368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
- Lucas Chamberlain
- Aleeia Chambers
- Bree Joslyn Chambers
- Brooke A. Chambers
- Christina Lyn Chambers
- Champion Family Chiropractic, P.C.
- Cynthia M Chan
- Nyabuoy Chan
- Cassandra Chance
- Jillian Ann Chance
All providers in Lincoln, NE · Physical Therapist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.