Active NPI
Kelsey Beth Schomburg Peters
- Speech-Language Pathologist
- Omaha, NE
National Provider Identifier
1124670153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2367
- Practice address
- 12828 Augusta Ave
Omaha, NE 68144-3733 - Phone
- (712) 310-1972
- NPI assigned
- Jul 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2367 | NE | Primary |
Addresses
Primary practice location
12828 Augusta Ave
Omaha, NE 68144-3733
Mailing address
924 S 38TH St
Omaha, NE 68105-1819
Phone (712) 310-1972
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2367 | NE | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1124670153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 S 38TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051819",
"telephone_number": "712-310-1972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12828 AUGUSTA AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681443733",
"telephone_number": "712-310-1972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "KELSEY",
"middle_name": "BETH SCHOMBURG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-10",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "2367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.