Individual provider Active NPI

Tessa Roberts

  • Clinical Social Worker
  • Grand Island, NE
National Provider Identifier
1174079446
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7028 Issued in NE
Practice address
3532 W Capital Ave
Grand Island, NE 68803-1205
Phone
(308) 381-7487
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10736 NE
Clinical Social Worker 1041C0700X 7028 NE Primary

Addresses

Primary practice location

3532 W Capital Ave
Grand Island, NE 68803-1205

Mailing address

3532 W Capital Ave
Grand Island, NE 68803-1205
Phone (308) 381-7487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020003941 NE Practitioner - Clinical Social Worker 1850711441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jessica Hunt, Limhp, LLCGroup PAC ID 5597185173, 7 clinicians
Quality Healthcare ClinicGroup PAC ID 4183860455, 6 clinicians

Practice addresses (Care Compare)

1809 N Kansas Ave
Hastings, NE 68901-2604
Phone (402) 834-0884

301 S Way Ave
Sutton, NE 68979-2134
Phone (402) 773-0115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10736NEMDMental Health Counselor
7028NEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Healthcare Clinic CurrentSince May 31, 2024 Accepting new patients
Jessica Hunt, Limhp, LLC CurrentSince Sep 18, 2020 Accepting new patients
Alivation Health, LLC Past Accepting new patients
Family Resources of Greater Nebraska PC Mental Health PastSince Oct 1, 2000 Accepting new patients

Locations

1423 7th St
Aurora, NE 68818
Phone (402) 694-3171

905 2nd St
Friend, NE 68359
Phone (402) 947-2541

303 N Burlington Ave
Ste C
Hastings, NE 68901
Phone (402) 834-0884

1809 N Kansas Ave
Hastings, NE 68901
Phone (402) 834-0884

301 S Way Ave
Sutton, NE 68979
Phone (402) 773-0115

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6128/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1174079446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688031205",
            "telephone_number": "308-381-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688031205",
            "telephone_number": "308-381-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10736",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "7028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.