Active NPI
Vanessa Pine
- Physical Therapist
- Omaha, NE
National Provider Identifier
1093050353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305207479
- Practice address
- 11506 Nicholas St
Ste 110
Omaha, NE 68154-4407 - Phone
- (877) 230-3885
- Fax
- (402) 505-9753
- NPI assigned
- Nov 27, 2012
- 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 | 2305207479 | VA | Primary |
Addresses
Primary practice location
11506 Nicholas St
Ste 110
Omaha, NE 68154-4407
Mailing address
2449 E Waters Edge Dr
Columbia City, IN 46725-8996
Phone (260) 609-8749
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 |
|---|---|---|---|
| 2305207479 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fusion Medical Staffing | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- East Stroudsburg, PA
- NPI 1922372416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1093050353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2449 E WATERS EDGE DR",
"city": "COLUMBIA CITY",
"state": "IN",
"postal_code": "467258996",
"telephone_number": "260-609-8749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11506 NICHOLAS ST",
"address_2": "STE 110",
"city": "OMAHA",
"state": "NE",
"postal_code": "681544407",
"telephone_number": "877-230-3885",
"fax_number": "402-505-9753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINE",
"first_name": "VANESSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-27",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305207479",
"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 Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.