Spectrum Mental Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SPECTRUM MENTAL WELLNESS LLC

Practice address

919 Galvin Rd S Ste a
Bellevue, NE 68005-2207

Phone

(402) 939-6623

Fax

(402) 625-0664

NPI assigned

Sep 13, 2023

Organization subpart

No

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

Authorized official

Name

Darrel Gene Moreland III, APRN-NP

Title

Owner, Nurse Practitioner

Phone

(402) 939-6623

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1235916271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 GALVIN RD S STE A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052207",
            "telephone_number": "402-939-6623",
            "fax_number": "402-625-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 GALVIN RD S STE A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052207",
            "telephone_number": "402-939-6623",
            "fax_number": "402-625-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
        "authorized_official_telephone_number": "402-939-6623",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "APRN-NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10027957600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Side Convenient Care Inc
• Joseph William South
• Marvilyn Southward
• Nicole Sova, PT
• Kelly Spath, RN
• Spectrum Mental Wellness LLC
• Aaron Spencer
• Jordan R Spencer, APRN
• Cheyenne Spicka
• Sarah Jane Spies, OTD

• Psychiatric/Mental Health Nurse Practitioner in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.