Individual provider Active NPI

Amanda Jensen, DC

  • Chiropractor
  • Lincoln, NE
National Provider Identifier
1114697299
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2104 Issued in NE
Practice address
2917 Pine Lake Rd Ste F
Lincoln, NE 68516-6032
Phone
(402) 972-8382
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2104 NE Primary

Addresses

Primary practice location

2917 Pine Lake Rd Ste F
Lincoln, NE 68516-6032

Mailing address

2917 Pine Lake Rd Ste F
Lincoln, NE 68516-6032
Phone (402) 972-8382

Other identifiers 1

IdentifierTypeStateIssuer
10026904100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105002931 NE Practitioner - Chiropractic 6305237108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2104NEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Chiropractic, LLC Chiropractor CurrentSince Jan 4, 2022 Accepting new patients
Thrive Family Chiropractic & Acupuncture Inc Chiropractor CurrentSince Sep 1, 2021 Accepting new patients

Locations

2917 Pine Lake Rd
Ste F
Lincoln, NE 68516
Phone (402) 615-6022

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1114697299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 PINE LAKE RD STE F",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166032",
            "telephone_number": "402-972-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 PINE LAKE RD STE F",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166032",
            "telephone_number": "402-972-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "2104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026904100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.

Verify at the official NPI Registry.