Individual provider Active NPI

Deborah J Wiezorek

  • Adult Development & Aging Psychologist
  • Lincoln, NE
National Provider Identifier
1336936236
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Practice address
5436 Enterprise Dr
Lincoln, NE 68521-1063
Phone
(402) 515-7449
NPI assigned
Apr 23, 2025
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X NE Primary

Addresses

Primary practice location

5436 Enterprise Dr
Lincoln, NE 68521-1063

Mailing address

5436 Enterprise Dr
Lincoln, NE 68521-1063
Phone (402) 515-7449

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

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1336936236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5436 ENTERPRISE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685211063",
            "telephone_number": "402-515-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5436 ENTERPRISE DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685211063",
            "telephone_number": "402-515-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEZOREK",
        "first_name": "DEBORAH",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NE",
            "license": null,
            "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 Apr 23, 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.