Active NPI
Shane Michael Sedlak
- Behavior Technician
- Omaha, NE
National Provider Identifier
1356190839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-345833
- Practice address
- 1299 Farnam St Ste 300
Omaha, NE 68102-1857 - Phone
- (402) 969-6633
- Fax
- (855) 892-0299
- NPI assigned
- May 16, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-345833 | NE | Primary |
Addresses
Primary practice location
1299 Farnam St Ste 300
Omaha, NE 68102-1857
Mailing address
1299 Farnam St Ste 300
Omaha, NE 68102-1857
Phone (402) 969-6633
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-345833 | NE | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1356190839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1299 FARNAM ST STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681021857",
"telephone_number": "402-969-6633",
"fax_number": "855-892-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1299 FARNAM ST STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681021857",
"telephone_number": "402-969-6633",
"fax_number": "855-892-0299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDLAK",
"first_name": "SHANE",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-16",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NE",
"license": "RBT-24-345833",
"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 May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.