Individual provider Active NPI

Andrew Kamerman

  • Pediatric Chiropractor
  • Omaha, NE
National Provider Identifier
1174900799
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
1788 Issued in NE
Practice address
11304 Davenport St
Omaha, NE 68154-2630
Phone
(269) 492-5546
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1788 NE
Pediatric Chiropractor 111NP0017X 1788 NE Primary

Addresses

Primary practice location

11304 Davenport St
Omaha, NE 68154-2630

Mailing address

11320 Davenport St
Omaha, NE 68154-2630
Phone (269) 492-5546

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1788NEMDPediatric Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Life Chiropractor CurrentSince Sep 28, 2025 Accepting new patients

Locations

11320 Davenport St
Omaha, NE 68154
Phone (402) 515-3571

Organizations & group practices 1

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": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1174900799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542630",
            "telephone_number": "269-492-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11304 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542630",
            "telephone_number": "269-492-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMERMAN",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1788",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "NE",
            "license": "1788",
            "primary": true
        }
    ],
    "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 Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.