Individual provider Active NPI

Jaime Robertson

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1124979307
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
116585 Issued in NE
Practice address
4350 Dewey Ave # Ne68105
Omaha, NE 68105-1017
Phone
(402) 552-2000
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95868 NE
Family Nurse Practitioner 363LF0000X 116585 NE Primary

Addresses

Primary practice location

4350 Dewey Ave # Ne68105
Omaha, NE 68105-1017

Mailing address

814 S 33Rd St
Omaha, NE 68105-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260416000496 NE Practitioner - Nurse Practitioner 6406322577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Wound Care NE IncGroup PAC ID 1759807977, 5 clinicians

Practice addresses (Care Compare)

650 J St
Suite 405
Lincoln, NE 68508-2924
Phone (801) 815-6862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95868NEMDRegistered Nurse
116585NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Wound Care NE Inc CurrentSince Apr 7, 2026 Accepting new patients

Locations

650 J St
Ste 405
Lincoln, NE 68508
Phone (801) 815-6500

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": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1124979307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 S 33RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 DEWEY AVE # NE68105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051017",
            "telephone_number": "402-552-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JAIME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "95868",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "116585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.