Active NPI
Lisa C. Hellbusch, DPT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1063716603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2898
- Practice address
- 16120 W Dodge Rd
Omaha, NE 68118-2049 - Phone
- (402) 354-0410
- Fax
- (402) 354-0415
- NPI assigned
- Dec 22, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2898 | NE | Primary |
Addresses
Primary practice location
16120 W Dodge Rd
Omaha, NE 68118-2049
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025895900 | Medicaid | NE | |
| 10026056700 | Medicaid | NE | |
| 10025941700 | Medicaid | NE | |
| 10026252200 | Medicaid | NE | |
| 10025896000 | Medicaid | NE | |
| 10025896100 | Medicaid | NE | |
| 1063716603 | Medicaid | IA | |
| 10026445500 | Medicaid | NE |
Other names 1
- Lisa C. Graham
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2898 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447372800000",
"number": "1063716603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-2100",
"fax_number": "402-354-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16120 W DODGE RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182049",
"telephone_number": "402-354-0410",
"fax_number": "402-354-0415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLBUSCH",
"first_name": "LISA",
"middle_name": "C.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-22",
"last_updated": "2015-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "2898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025895900",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026056700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025941700",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026252200",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025896000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025896100",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063716603",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026445500",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "GRAHAM",
"middle_name": "C.",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 13, 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.