Individual provider Active NPI

Patricia Ann Daberkow, MS-CCC/SLP

  • Speech-Language Pathologist
  • Lincoln, NE
National Provider Identifier
1154886190
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
727 Issued in NE
Practice address
300 S 48TH St
Lincoln, NE 68510-1830
Phone
(402) 436-1935
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 727 NE Primary

Addresses

Primary practice location

300 S 48TH St
Lincoln, NE 68510-1830

Mailing address

6556 South 32ND St.
Lincoln, NE 68516
Phone (402) 420-7313

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

LicenseStateTypeSpecialty
727NEMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1154886190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6556 SOUTH 32ND ST.",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68516",
            "telephone_number": "402-420-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101830",
            "telephone_number": "402-436-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABERKOW",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "727",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 4, 2019; 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.