NPIMap

Organization Active NPI

Diversified Mobile PT LLC

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1164289880
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DIVERSIFIED MOBILE PT LLC
Practice address
5114 N 137TH St
Omaha, NE 68164-6191
Phone
(402) 819-7956
Fax
(531) 201-6077
NPI assigned
Feb 29, 2024
Last updated
May 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Authorized official

Name
Dr. Nicole Kristine Dickmeyer, PT, DPTNPI 1821390378
Title
Owner
Phone
(402) 317-9120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

5114 N 137TH St
Omaha, NE 68164-6191

Mailing address

5114 N 137TH St
Omaha, NE 68164-6191
Phone (402) 819-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240327000271 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0547607467 Receives reassigned benefits from 13 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1164289880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 N 137TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681646191",
            "telephone_number": "402-819-7956",
            "fax_number": "531-201-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 N 137TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681646191",
            "telephone_number": "402-819-7956",
            "fax_number": "531-201-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED MOBILE PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "DICKMEYER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-317-9120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.