Active NPI
Charles Roy Behrendt, RN, BSN
- Registered Nurse
- Omaha, NE
National Provider Identifier
1235976192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 140
- Practice address
- 4101 Woolworth Ave
Omaha, NE 68105-1850 - Phone
- (402) 995-4148
- NPI assigned
- Jul 9, 2024
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 140 | IA | Primary |
Addresses
Primary practice location
4101 Woolworth Ave
Omaha, NE 68105-1850
Mailing address
213 Woodcliff Cir
Council Bluffs, IA 51503-4289
Phone (712) 579-6228
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140 | IA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1235976192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 WOODCLIFF CIR",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034289",
"telephone_number": "712-579-6228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEHRENDT",
"first_name": "CHARLES",
"middle_name": "ROY",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "140",
"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 Jul 18, 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.