Individual provider Active NPI

Jacki Haley, BSN

  • Registered Nurse
  • Kearney, NE
National Provider Identifier
1114790532
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
65766 Issued in NE
Practice address
516 W 11TH St Ste 108B
Kearney, NE 68845-7310
Phone
(308) 233-3100
Fax
(308) 455-4182
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 65766 NE Primary

Addresses

Primary practice location

516 W 11TH St Ste 108B
Kearney, NE 68845-7310

Mailing address

516 W 11TH St Ste 108B
Kearney, NE 68845-7310
Phone (308) 233-3100

Other names 1

  • Jacki Connery Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
65766NEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Two Rivers Public Health Department CurrentSince Nov 12, 2023 Accepting new patients

Locations

516 W 11th St
Ste 108B
Kearney, NE 68845
Phone (308) 233-3100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1114790532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W 11TH ST STE 108B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688457310",
            "telephone_number": "308-233-3100",
            "fax_number": "308-455-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W 11TH ST STE 108B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688457310",
            "telephone_number": "308-233-3100",
            "fax_number": "308-455-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "JACKI",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "65766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKI",
            "last_name": "CONNERY",
            "credential": "BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.