NPIMap

Organization Active NPI

Educational Service Unit 13

  • Psychologist
  • Scottsbluff, NE
National Provider Identifier
1104393545
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
EDUCATIONAL SERVICE UNIT 13
Practice address
4215 Avenue I
Scottsbluff, NE 69361-4902
Phone
(308) 635-3696
NPI assigned
Oct 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Authorized official

Name
Theresa Reimers
Title
Office Manager
Phone
(308) 254-4677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

4215 Avenue I
Scottsbluff, NE 69361-4902

Mailing address

4215 Avenue I
Scottsbluff, NE 69361-4902
Phone (308) 635-3696

Other identifiers 1

IdentifierTypeStateIssuer
10026729600MedicaidNE

National Provider Directory

National Provider Directory

Locations

4215 Avenue I
Scottsbluff, NE 69361
Phone (308) 635-3696

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594684800000",
    "number": "1104393545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 AVENUE I",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614902",
            "telephone_number": "308-635-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 AVENUE I",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614902",
            "telephone_number": "308-635-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATIONAL SERVICE UNIT 13",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A",
        "authorized_official_last_name": "REIMERS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "308-254-4677"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026729600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.