Active NPI
Chad D Doerneman, PT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1215229109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3010
- Practice address
- 119 N 51St St
Suite 101
Omaha, NE 68132-2867 - Phone
- (102) 506-5695
- Fax
- (402) 596-6758
- NPI assigned
- May 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3010 | NE | Primary |
Addresses
Primary practice location
119 N 51St St
Suite 101
Omaha, NE 68132-2867
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47627 | Other | NE | BLUE CROSS BLUE SHIELD |
| P01003067 | Other | NE | RAILROAD MEDICARE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466812800000",
"number": "1215229109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 N 51ST ST",
"address_2": "SUITE 101",
"city": "OMAHA",
"state": "NE",
"postal_code": "681322867",
"telephone_number": "102-506-5695",
"fax_number": "402-596-6758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOERNEMAN",
"first_name": "CHAD",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-10",
"last_updated": "2016-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3010",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "47627",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01003067",
"state": "NE"
}
],
"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 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.