Active NPI
Jay Lawrence Spracklen, P.T.
- Physical Therapist
- Lincoln, NE
National Provider Identifier
1124198213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1233
- Practice address
- 2845 S 70TH St
Lincoln, NE 68506 - Phone
- (402) 489-1999
- Fax
- (402) 489-4153
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1233 | NE | Primary |
Addresses
Primary practice location
2845 S 70TH St
Lincoln, NE 68506
Mailing address
2845 S 70TH St
Lincoln, NE 68506
Phone (402) 489-1999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76058051000 | Medicaid | NE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1233 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225843200000",
"number": "1124198213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2845 S 70TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68506",
"telephone_number": "402-489-1999",
"fax_number": "402-489-4153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 S 70TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68506",
"telephone_number": "402-489-1999",
"fax_number": "402-489-4153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRACKLEN",
"first_name": "JAY",
"middle_name": "LAWRENCE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2008-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "1233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76058051000",
"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 Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.