Individual provider Active NPI

Megan Marie Nickles, M.S. CF-SLP

  • Speech-Language Pathologist
  • Lincoln, NE
National Provider Identifier
1356989453
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
720 Issued in NE
Practice address
300 S 48TH St
Lincoln, NE 68510-1830
Phone
(402) 436-1895
NPI assigned
Dec 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 720 NE Primary

Addresses

Primary practice location

300 S 48TH St
Lincoln, NE 68510-1830

Mailing address

3110 Wilderness Hill Blvd Apt 6-309
Lincoln, NE 68516-5183
Phone (563) 370-9887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908003946 NE Practitioner - Qualified Speech Language Pathologist 3274939764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2500NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home CurrentSince Aug 9, 2021 Accepting new patients
ENT Services PC Speech-Language Pathologist Past Accepting new patients
Father Flanagan's Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

425 N 30th St
Omaha, NE 68131
Phone (402) 452-5000

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

Organizations & group practices 3

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": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1356989453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 WILDERNESS HILL BLVD APT 6-309",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165183",
            "telephone_number": "563-370-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685101830",
            "telephone_number": "402-436-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "720",
            "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 Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.