Individual provider Active NPI

Julia L Black, DO

  • Sports Medicine (Family Medicine) Physician
  • Omaha, NE
National Provider Identifier
1114379872
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
2258 Issued in NE
Practice address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone
(402) 637-0800
Fax
(402) 637-0808
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-05227 IA
Family Medicine Physician 207Q00000X R10715 IA
Sports Medicine (Family Medicine) Physician 207QS0010X 94-10056 KS
Sports Medicine (Family Medicine) Physician 207QS0010X DO-05227 IA
Sports Medicine (Family Medicine) Physician 207QS0010X 2258 NE Primary

Addresses

Primary practice location

2725 S 144TH St Ste 212
Omaha, NE 68144-5253

Mailing address

2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 637-0800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address onclinic@orthonebraska.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 24, 2025 through Jun 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2258NEMDChiropractor
R10715IAMDFamily Medicine Physician
94-10056KSMDSports Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1114379872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-637-0800",
            "fax_number": "402-637-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-637-0800",
            "fax_number": "402-637-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JULIA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-05227",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R10715",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KS",
            "license": "94-10056",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IA",
            "license": "DO-05227",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NE",
            "license": "2258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "onclinic@orthonebraska.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2725 S 144th St Ste 212",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681445253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.