Individual provider Active NPI

Rebecca Ann Wiemers, LCSW

  • Clinical Social Worker
  • McCook, NE
National Provider Identifier
1366879165
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4307 Issued in NE
Practice address
212 E 1St St
MC Cook, NE 69001-3712
Phone
(308) 345-4884
Fax
(308) 345-2366
NPI assigned
Oct 11, 2013
Last updated
Mar 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4307 NE Primary

Addresses

Primary practice location

212 E 1St St
MC Cook, NE 69001-3712

Mailing address

212 E 1St St
MC Cook, NE 69001-3712
Phone (308) 345-4884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922002137 NE Practitioner - Clinical Social Worker 7618196742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unified Therapy Clinic, P.C.Group PAC ID 6800015934, 2 clinicians

Practice addresses (Care Compare)

212 E 1St St
MC Cook, NE 69001-3712
Phone (308) 345-4884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4307NEMDMental Health Counselor
1522NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Unified Therapy Clinic, P.C. CurrentSince Aug 28, 2014 Accepting new patients

Locations

212 E 1st St
McCook, NE 69001
Phone (308) 345-4884

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1366879165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E 1ST ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013712",
            "telephone_number": "308-345-4884",
            "fax_number": "308-345-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E 1ST ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013712",
            "telephone_number": "308-345-4884",
            "fax_number": "308-345-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMERS",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-11",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "4307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McCook, NE

Sources for this page

Verify at the official NPI Registry.