Individual provider Active NPI

Linda E Janeczko, P.T.

  • Pediatric Physical Therapist
  • Papillion, NE
National Provider Identifier
1386781854
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
747 Issued in NE
Practice address
506 Windsor Dr
Papillion, NE 68046-4154
Phone
(402) 339-8705
Fax
(402) 339-3157
NPI assigned
Jan 31, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 747 NE Primary
Pediatric Physical Therapist 2251P0200X 927 MN

Addresses

Primary practice location

506 Windsor Dr
Papillion, NE 68046-4154

Mailing address

506 Windsor Dr
Papillion, NE 68046-4154
Phone (402) 339-8705

Other identifiers 2

IdentifierTypeStateIssuer
47-071456700MedicaidNE
09111OtherNEBC BS OF NEBRASKA

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

LicenseStateTypeSpecialty
747NEMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386781854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 WINDSOR DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464154",
            "telephone_number": "402-339-8705",
            "fax_number": "402-339-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 WINDSOR DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464154",
            "telephone_number": "402-339-8705",
            "fax_number": "402-339-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANECZKO",
        "first_name": "LINDA",
        "middle_name": "E",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NE",
            "license": "747",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MN",
            "license": "927",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-071456700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF NEBRASKA",
            "identifier": "09111",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.