Active NPI
David A Jasper, M.D.
- Internal Medicine Physician
- Omaha, NE
National Provider Identifier
1164615571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 11480
- Practice address
- 17030 Lakeside Hills PLZ
#102
Omaha, NE 68130-2396 - Phone
- (402) 758-5800
- Fax
- (402) 758-5809
- NPI assigned
- Aug 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11480 | NE | Primary |
Addresses
Primary practice location
17030 Lakeside Hills PLZ
#102
Omaha, NE 68130-2396
Mailing address
17030 Lakeside Hills PLZ
#102
Omaha, NE 68130-2396
Phone (402) 758-5800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04435 | Other | NE | BCBS - D4S |
| 04430 | Other | NE | BCBS - IMP |
| 042914 | Other | NE | UHC SHARE ADVANTAGE D4S |
| 6398 | Other | NE | MIDLANDS CHOICE |
| 042913 | Other | NE | UHC SHARE ADVANTAGE IMP |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11480 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196640000000",
"number": "1164615571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17030 LAKESIDE HILLS PLZ",
"address_2": "#102",
"city": "OMAHA",
"state": "NE",
"postal_code": "681302396",
"telephone_number": "402-758-5800",
"fax_number": "402-758-5809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17030 LAKESIDE HILLS PLZ",
"address_2": "#102",
"city": "OMAHA",
"state": "NE",
"postal_code": "681302396",
"telephone_number": "402-758-5800",
"fax_number": "402-758-5809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASPER",
"first_name": "DAVID",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-20",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NE",
"license": "11480",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - D4S",
"identifier": "04435",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - IMP",
"identifier": "04430",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC SHARE ADVANTAGE D4S",
"identifier": "042914",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "6398",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC SHARE ADVANTAGE IMP",
"identifier": "042913",
"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 Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.