Active NPI
Cottam Psychological Services P.C.
- Clinical Psychologist
- Omaha, NE
National Provider Identifier
1104012970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- COTTAM PSYCHOLOGICAL SERVICES P.C.
- Practice address
- 2730 S. 87TH Ave.
Omaha, NE 68124-3045 - Phone
- (402) 331-8085
- Fax
- (402) 331-8265
- NPI assigned
- Sep 14, 2007
- Organization subpart
- Yes
- Parent organization
- COTTAM PSYCHOLOGICAL SERVICES P.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Catherine Colegrove
- Title
- Office Manager
- Phone
- (402) 331-8085
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
2730 S. 87TH Ave.
Omaha, NE 68124-3045
Mailing address
2730 S. 87TH Ave.
Omaha, NE 68124-3045
Phone (402) 331-8085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110928000540 | NE | Part B Supplier - Clinic/Group Practice | 6204007909 |
Receives reassigned benefits from 1 practitioner Practice locations: Omaha, NE |
National Provider Directory
National Provider Directory- Part of
- Cottam Psychological Services PC
Locations
1246 Golden Gate Dr
Ste 4
Papillion, NE 68046
Phone (402) 331-8085
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320624000000",
"number": "1104012970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 S. 87TH AVE.",
"city": "OMAHA",
"state": "NE",
"postal_code": "681243045",
"telephone_number": "402-331-8085",
"fax_number": "402-331-8265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 S. 87TH AVE.",
"city": "OMAHA",
"state": "NE",
"postal_code": "681243045",
"telephone_number": "402-331-8085",
"fax_number": "402-331-8265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COTTAM PSYCHOLOGICAL SERVICES P.C.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COTTAM PSYCHOLOGICAL SERVICES P.C.",
"enumeration_date": "2007-09-14",
"last_updated": "2011-11-07",
"status": "A",
"authorized_official_last_name": "COLEGROVE",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "CATHERINE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "402-331-8085"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"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 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.