Active NPI
Jacqueline Anderegg, MSW
- Clinical Social Worker
- Omaha, NE
National Provider Identifier
1164582276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 98 LMHP 121 LCSW
- Practice address
- 4030 S 173Rd Cir
Omaha, NE 68130-2216 - Phone
- (402) 397-7221
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 98 LMPH 121 MSW | NE | |
| Clinical Social Worker | 1041C0700X | 98 LMHP 121 LCSW | NE | Primary |
Addresses
Primary practice location
4030 S 173Rd Cir
Omaha, NE 68130-2216
Mailing address
4030 South 173Rd Circle
Omaha, NE 68130-2216
Phone (402) 397-7221
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82060 | Other | NE | BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98 LMPH 121 MSW | NE | MD | Social Worker |
| 98 LMHP 121 LCSW | NE | MD | Clinical Social Worker |
| 121 | NE | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1164582276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 SOUTH 173RD CIRCLE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681302216",
"telephone_number": "402-397-7221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4030 S 173RD CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681302216",
"telephone_number": "402-397-7221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDEREGG",
"first_name": "JACQUELINE",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NE",
"license": "98 LMPH 121 MSW",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "98 LMHP 121 LCSW",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "82060",
"state": "NE"
}
],
"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 Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.