Individual provider Active NPI

Jacalyn Kliewer, DPT

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1275415754
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4844 Issued in NE
Practice address
4130 Pioneer Woods Dr Ste 1
Lincoln, NE 68506-7552
Phone
(402) 489-4700
NPI assigned
Jul 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4844 NE Primary

Addresses

Primary practice location

4130 Pioneer Woods Dr Ste 1
Lincoln, NE 68506-7552

Mailing address

9941 S 37TH St
Apt 221
Lincoln, NE 68516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819000544 NE Practitioner - Physical Therapist in Private Practice 0446759211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Orthopaedic and Plastic Surgery PCGroup PAC ID 0345344818, 23 clinicians

Practice addresses (Care Compare)

4130 Pioneer Woods Dr
Suite 1
Lincoln, NE 68506-7552
Phone (402) 489-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Orthopaedic & Plastic Surgery, P.C. Physical Therapist CurrentSince Jul 22, 2025 Accepting new patients
Prairie Orthopaedic & Plastic Surgery, PC CurrentSince Jul 22, 2025 Accepting new patients

Locations

4130 Pioneer Woods Dr
Ste 1
Lincoln, NE 68506
Phone (402) 489-4700

5901 N 28th St
Lincoln, NE 68504
Phone (402) 489-4700

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1275415754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9941 S 37TH ST",
            "address_2": "APT 221",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 1",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-489-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIEWER",
        "first_name": "JACALYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.