Active NPI
Lamar Dupree Jackson
- Chore Provider
- Omaha, NE
National Provider Identifier
1215744248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chore Provider
- Practice address
- 4156 Burt St
Omaha, NE 68131-1758 - Phone
- (402) 807-9734
- NPI assigned
- Dec 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chore Provider | 372500000X | NE | Primary |
Addresses
Primary practice location
4156 Burt St
Omaha, NE 68131-1758
Mailing address
4156 Burt St
Omaha, NE 68131-1758
Phone (402) 807-9734
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1215744248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4156 BURT ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681311758",
"telephone_number": "402-807-9734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4156 BURT ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681311758",
"telephone_number": "402-807-9734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LAMAR",
"middle_name": "DUPREE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-12",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chore Provider",
"state": "NE",
"license": null,
"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 Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.