Active NPI
Michaela Peck, OT
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1336719715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2556
- Practice address
- 7686 Walnut St
Omaha, NE 68124-1717 - Phone
- (402) 819-8477
- NPI assigned
- Jun 29, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2556 | NE | Primary |
Addresses
Primary practice location
7686 Walnut St
Omaha, NE 68124-1717
Mailing address
3514 California St
Omaha, NE 68131-1910
Phone (402) 344-0722
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2556 | NE | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1336719715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3514 CALIFORNIA ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681311910",
"telephone_number": "402-344-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7686 WALNUT ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681241717",
"telephone_number": "402-819-8477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "MICHAELA",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2556",
"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 Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.