Active NPI
Chad Jacobson, PT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1093094658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3083
- Practice address
- 2403 S 133Rd PLZ
Omaha, NE 68144-5905 - Phone
- (402) 330-8433
- Fax
- (402) 330-8616
- NPI assigned
- Aug 12, 2011
- Last updated
- Jun 28, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 3083 | NE | Primary |
Addresses
Primary practice location
2403 S 133Rd PLZ
Omaha, NE 68144-5905
Mailing address
2403 S 133Rd PLZ
Omaha, NE 68144-5905
Phone (402) 330-8433
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3083 | NE | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excel Rehabilitation Inc | Physical Therapist | 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, 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": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1093094658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 S 133RD PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445905",
"telephone_number": "402-330-8433",
"fax_number": "402-330-8616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2403 S 133RD PLZ",
"city": "OMAHA",
"state": "NE",
"postal_code": "681445905",
"telephone_number": "402-330-8433",
"fax_number": "402-330-8616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "CHAD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-12",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3083",
"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 Jun 28, 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.