Individual provider Active NPI

Sophia Josephine Bardales

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1083334361
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
923 Issued in NE
Practice address
3925 S 147TH St Ste 109-111
Omaha, NE 68144-5565
Phone
(402) 942-1329
Fax
(402) 606-4664
NPI assigned
Aug 29, 2022
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 923 NE Primary

Addresses

Primary practice location

3925 S 147TH St Ste 109-111
Omaha, NE 68144-5565

Mailing address

3925 S 147TH St Ste 109-111
Omaha, NE 68144-5565
Phone (402) 942-1329

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

LicenseStateTypeSpecialty
923NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Schmidt Speech Language Pathology Services LLC Speech-Language Pathologist CurrentSince Sep 4, 2022 Accepting new patients

Locations

3925 S 147th St
Ste 109111
Omaha, NE 68144

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1083334361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 S 147TH ST STE 109-111",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445565",
            "telephone_number": "402-942-1329",
            "fax_number": "402-606-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 S 147TH ST STE 109-111",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445565",
            "telephone_number": "402-942-1329",
            "fax_number": "402-606-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDALES",
        "first_name": "SOPHIA",
        "middle_name": "JOSEPHINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "923",
            "primary": true
        }
    ],
    "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 Aug 29, 2022; 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.