Daniel G Fender, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6467 Issued in NE

Practice address

2501 Capehart Rd
Suite 2
Offutt AFB, NE 68113-1043

Phone

(402) 274-8018

NPI assigned

Jun 6, 2008

Last updated

Dec 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellevue Primary Healthcare PCGroup PAC ID 2860639051, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11675/brand/1/csg/1/fhir/r4

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.

• Bellevue Primary Healthcare PC

  • Family Medicine Physician
  • Bellevue, NE
  • NPI 1497091888
  Medicare reassignment Care Compare group NPD
• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490
  NPD

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1083873806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "address_2": "SUITE 2",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-274-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDER",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "7872",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "6467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025559800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John P Engler, PH.D.
• Erhling Berquist Hospital
• Anthony Charles Eschliman, D.O.
• Orlesha Diane Fairgood, LICSW
• David Faith
• Edwin Fernandez Jr., DNP, APRN, FNP-C
• Christopher L Fillmore, MD
• Jan Fink
• Vivianle B Freeman, O.D.
• William Freeman, MD

• Clinical Social Worker in Offutt AFB, NE
• Providers in Offutt AFB, NE by specialty
• Clinical Social Worker in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.