Individual provider Active NPI

Nicholas Rasmussen

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1053796425
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005122 Issued in IA
Practice address
16417 Ames Ave
Omaha, NE 68116-2937
Phone
(319) 321-1536
NPI assigned
Jul 27, 2015
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005122 IA Primary
Physical Therapist 225100000X 40930 CA

Addresses

Primary practice location

16417 Ames Ave
Omaha, NE 68116-2937

Mailing address

16417 Ames Ave
Omaha, NE 68116-2937
Phone (319) 321-1536

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40930CAMDMarriage & Family Therapist
005122IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1053796425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16417 AMES AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162937",
            "telephone_number": "319-321-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16417 AMES AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162937",
            "telephone_number": "319-321-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "005122",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40930",
            "primary": false
        }
    ],
    "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 27, 2015; 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.