Active NPI
Mary T Johannes, RN
- Registered Nurse
- Omaha, NE
National Provider Identifier
1285068122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 71410
- Practice address
- 11111 M St
Omaha, NE 68137-2378 - Phone
- (402) 504-4099
- Fax
- (402) 504-3929
- NPI assigned
- Aug 28, 2013
- Last updated
- Aug 28, 2013
- Sex
- Female
- 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 | 71410 | NE | Primary |
Addresses
Primary practice location
11111 M St
Omaha, NE 68137-2378
Mailing address
3300 N 60TH St
Omaha, NE 68104-3402
Phone (402) 554-0520
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71410 | NE | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1285068122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 N 60TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681043402",
"telephone_number": "402-554-0520",
"fax_number": "402-551-8797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11111 M ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372378",
"telephone_number": "402-504-4099",
"fax_number": "402-504-3929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANNES",
"first_name": "MARY",
"middle_name": "T",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-28",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NE",
"license": "71410",
"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 Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.