Individual provider Active NPI

Chad Isaacson, OTR/L

  • Occupational Therapist
  • Minden, NE
National Provider Identifier
1336376334
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
882 Issued in NE
Practice address
244 N Minden Ave
Minden, NE 68959-1643
Phone
(308) 832-1500
Fax
(308) 832-1551
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 882 NE Primary

Addresses

Primary practice location

244 N Minden Ave
Minden, NE 68959-1643

Mailing address

244 N Minden Ave
Minden, NE 68959-1643
Phone (308) 832-1500

Other identifiers 1

IdentifierTypeStateIssuer
882OtherNESTATE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000750 NE Practitioner - Occupational Therapist in Private Practice 2062555915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Physical Therapy and Sports Center 36 clinicians

Practice addresses (Care Compare)

211 W 33Rd St
Suite a
Kearney, NE 68845-3485
Phone (308) 236-5884

244 N Minden Ave
Minden, NE 68959-1643
Phone (308) 832-1500

620 E 25TH St
Suite 7
Kearney, NE 68847-5529
Phone (308) 455-1781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
882NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physical Therapy & Sports Center CurrentSince Sep 1, 2009 Accepting new patients
Family Physical Therapy & Sports Center CurrentSince Sep 1, 2009 Accepting new patients
Family Physical Therapy & Sports Center Occupational Therapist Past Accepting new patients
Family Physical Therapy & Sports Center Past Accepting new patients

Locations

615 W 39th St
Ste A
Kearney, NE 68845
Phone (308) 698-2820

211 W 33rd St
Ste A
Kearney, NE 68845
Phone (308) 236-5884

3500 Central Ave
Ste C1
Kearney, NE 68847
Phone (308) 865-9200

110 W 5th St
Lexington, NE 68850
Phone (308) 324-3700

244 N Minden Ave
Minden, NE 68959
Phone (308) 832-1500

Organizations & group practices 4

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1336376334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N MINDEN AVE",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591643",
            "telephone_number": "308-832-1500",
            "fax_number": "308-832-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N MINDEN AVE",
            "city": "MINDEN",
            "state": "NE",
            "postal_code": "689591643",
            "telephone_number": "308-832-1500",
            "fax_number": "308-832-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACSON",
        "first_name": "CHAD",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "882",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minden, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.