Individual provider Active NPI

Abbie Carpenter, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • O'Neill, NE
National Provider Identifier
1205668290
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
115570 Issued in NE
Practice address
614 N 4TH St Ste 104
Oneill, NE 68763-1317
Phone
(402) 340-1210
NPI assigned
Aug 17, 2024
Last updated
Aug 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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 115570 NE Primary

Addresses

Primary practice location

614 N 4TH St Ste 104
Oneill, NE 68763-1317

Mailing address

614 N 4TH St Ste 104
Oneill, NE 68763-1317
Phone (402) 340-1210

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
I20240927002275 NE Practitioner - Nurse Practitioner 0345771622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

47452 268 Ave
Suite C
Humphrey, NE 68642-5178
Phone (402) 923-0150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115570NEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC Single Specialty CurrentSince Mar 10, 2025 Accepting new patients
Faith Regional Physician Services, LLC Single Specialty CurrentSince Mar 10, 2025 Accepting new patients
Abbie Enterprise LLC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

614 N 4th St
Ste 104
Oneill, NE 68763
Phone (402) 340-1210

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1205668290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 N 4TH ST STE 104",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631317",
            "telephone_number": "402-340-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 N 4TH ST STE 104",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631317",
            "telephone_number": "402-340-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ABBIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-17",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "115570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Neill, NE

Sources for this page

Verify at the official NPI Registry.