Individual provider Active NPI

Jensen Rose Antilla

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1295530202
Registry record updated Nov 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3063 Issued in NE
Practice address
2010 N 88TH St
Omaha, NE 68134-6102
Phone
(402) 496-1000
NPI assigned
Feb 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3063 NE Primary

Addresses

Primary practice location

2010 N 88TH St
Omaha, NE 68134-6102

Mailing address

5321 S 138TH St
Omaha, NE 68137-2913
Phone (402) 895-4000

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

State licenses

LicenseStateTypeSpecialty
3063NEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762041600000",
    "number": "1295530202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 S 138TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372913",
            "telephone_number": "402-895-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 N 88TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346102",
            "telephone_number": "402-496-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTILLA",
        "first_name": "JENSEN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "3063",
            "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 Nov 2, 2025; 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.