Active NPI
Jami R Kelly, R.D.H.
- Dental Hygienist
- Omaha, NE
National Provider Identifier
1205190766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2106
- Practice address
- 2602 J St
Omaha, NE 68107-1643 - Phone
- (402) 733-1325
- Fax
- (402) 734-1780
- NPI assigned
- Jun 29, 2012
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2106 | NE | Primary |
| Dental Hygienist | 124Q00000X | 03710 | IA |
Addresses
Primary practice location
2602 J St
Omaha, NE 68107-1643
Mailing address
3017 10TH Ave
Council Bluffs, IA 51501-5844
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03710 | IA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340928000000",
"number": "1205190766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3017 10TH AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515015844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2602 J ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681071643",
"telephone_number": "402-733-1325",
"fax_number": "402-734-1780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JAMI",
"middle_name": "R",
"credential": "R.D.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-29",
"last_updated": "2012-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NE",
"license": "2106",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IA",
"license": "03710",
"primary": false
}
],
"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 Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.