Active NPI
Jacqueline Jean Weller, P.T.
- Physical Therapist
- Omaha, NE
National Provider Identifier
1083731855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 416
- Practice address
- 11623 Arbor St
Omaha, NE 68144-2981 - Phone
- (402) 334-6064
- Fax
- (402) 334-6080
- NPI assigned
- Mar 24, 2007
- 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 | 416 | CO | Primary |
Addresses
Primary practice location
11623 Arbor St
Omaha, NE 68144-2981
Mailing address
61 Cuna Way
Red Feather Lakes, CO 80545-8847
Phone (970) 481-7886
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 |
|---|---|---|---|
| 416 | CO | MD | Rehabilitation Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083731855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 CUNA WAY",
"city": "RED FEATHER LAKES",
"state": "CO",
"postal_code": "805458847",
"telephone_number": "970-481-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11623 ARBOR ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442981",
"telephone_number": "402-334-6064",
"fax_number": "402-334-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "JACQUELINE",
"middle_name": "JEAN",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "416",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.