Active NPI
Audreana M Bombeck, PT
- Physical Therapist
- Grand Island, NE
National Provider Identifier
1073093340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3880
- Practice address
- 2116 Atlanta St
Grand Island, NE 68803-2373 - Phone
- (308) 390-6056
- NPI assigned
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 3880 | NE | Primary |
Addresses
Primary practice location
2116 Atlanta St
Grand Island, NE 68803-2373
Mailing address
2116 Atlanta St
Grand Island, NE 68803-2373
Phone (308) 390-6056
Other names 1
- Audreana M Aguilar
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 |
|---|---|---|---|
| 3880 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1073093340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2116 ATLANTA ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032373",
"telephone_number": "308-390-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2116 ATLANTA ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688032373",
"telephone_number": "308-390-6056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMBECK",
"first_name": "AUDREANA",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AUDREANA",
"last_name": "AGUILAR",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.