Individual provider Active NPI

Christian Nickole Klepper

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1104347038
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11212 Issued in NE
Practice address
444 S 44TH St
Omaha, NE 68131-3727
Phone
(402) 559-6408
Fax
(402) 559-5737
NPI assigned
Jun 30, 2017
Last updated
Jun 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11212 NE Primary

Addresses

Primary practice location

444 S 44TH St
Omaha, NE 68131-3727

Mailing address

985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (402) 559-6408

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191114001029 NE Practitioner - Clinical Psychologist 1557793437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
997NEMDAddiction (Substance Use Disorder) Counselor
11212NEMDPharmacist

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1104347038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S 44TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313727",
            "telephone_number": "402-559-6408",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEPPER",
        "first_name": "CHRISTIAN",
        "middle_name": "NICKOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "11212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.