Individual provider Active NPI

Rebecca Kay Olander, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1174762405
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
111229 Issued in NE
Practice address
5539 South 27TH St
Suite 101
Lincoln, NE 68512-1648
Phone
(402) 261-6212
Fax
(402) 817-4949
NPI assigned
Feb 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 111229 NE Primary

Addresses

Primary practice location

5539 South 27TH St
Suite 101
Lincoln, NE 68512-1648

Mailing address

5539 South 27TH St
Suite 101
Lincoln, NE 68512-1648
Phone (402) 261-6212

Other identifiers 1

IdentifierTypeStateIssuer
47070592313MedicaidNE

Other names 1

  • Ms. Rebecca Kay Tielke Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110510000058 NE Practitioner - Nurse Practitioner 8325224389 Practice locations: Lincoln, NE

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5539 S 27TH St
Suite 101
Lincoln, NE 68512-1600
Phone (402) 261-6212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1174762405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5539 SOUTH 27TH ST",
            "address_2": "SUITE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685121648",
            "telephone_number": "402-261-6212",
            "fax_number": "402-817-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5539 SOUTH 27TH ST",
            "address_2": "SUITE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685121648",
            "telephone_number": "402-261-6212",
            "fax_number": "402-817-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLANDER",
        "first_name": "REBECCA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "111229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47070592313",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "TIELKE",
            "middle_name": "KAY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.