Melissa Rae Blakemore | NPI 1134916596

Key facts

NPI: 1134916596
Entity type: Individual (NPI type 1)
Primary specialty: Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Practice address: 9012 Q St
Omaha, NE 68127-3549
Phone: (402) 315-1000
NPI assigned: Apr 21, 2025
Sex: Female
Sole proprietor: Yes

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.

Autism Center of Nebraska, Inc. Developmentally Disabled Services Day Training Agency · Omaha, NE · NPI 1588322382

NPD COMMUNITY BASED RESIDENTIAL TREATMENT FACILITY, INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Autism Center of Nebraska, Inc.	Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities	Current	Accepting new patients

Locations

9012 Q St
Omaha, NE 68127
Phone (402) 315-1000

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	320900000X			Yes

Addresses

Primary practice location

9012 Q St
Omaha, NE 68127-3549

Mailing address

9012 Q St
Omaha, NE 68127-3549
Phone (402) 315-1000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 21, 2025.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1134916596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681273549",
            "telephone_number": "402-315-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9012 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681273549",
            "telephone_number": "402-315-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMORE",
        "first_name": "MELISSA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

All providers in Omaha, NE · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.