Active NPI
Heidi Michelle Berthelsen
- Speech-Language Pathologist
- Omaha, NE
National Provider Identifier
1083188320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1390
- Practice address
- 4102 Woolworth Ave
Omaha, NE 68105-1851 - Phone
- (402) 444-7000
- NPI assigned
- Jan 21, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 001950 | IA | |
| Speech-Language Pathologist | 235Z00000X | 1390 | NE | Primary |
Addresses
Primary practice location
4102 Woolworth Ave
Omaha, NE 68105-1851
Mailing address
14107 Ames Ave
Omaha, NE 68164-5005
Phone (402) 968-9331
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 |
|---|---|---|---|
| 001950 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548028800000",
"number": "1083188320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14107 AMES AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681645005",
"telephone_number": "402-968-9331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051851",
"telephone_number": "402-444-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTHELSEN",
"first_name": "HEIDI",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-21",
"last_updated": "2019-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "001950",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "1390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
- Mark Bertch, PT, DPT, OCS, CSCS
- Carrie A. Bertellotti, APRN ACNP-BC
- Jacqueline Lynn Bertelsen, RD, LD, LMNT
- Makayla J Bertelson, APRN
- Brian Timothy Berthelsen, ATC
- Andrew Robert Berthold
- Joseph Francis Bertinetti, PH.D JD
- Brooke Bertling, M.A. CCC-SLP
- Nancy L. Bertolino, MS, RD, LMNT
- John M. Bertoni, M.D. /PH.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.