Individual provider Active NPI

Jessica A Knight, PSYD

  • Psychologist
  • Omaha, NE
National Provider Identifier
1396076451
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
857 Issued in NE
Practice address
7101 Newport Ave
Omaha, NE 68152-2164
Phone
(402) 572-2916
Fax
(402) 572-3258
NPI assigned
Jan 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3672 NE
Psychologist 103T00000X 857 NE Primary

Addresses

Primary practice location

7101 Newport Ave
Omaha, NE 68152-2164

Mailing address

7261 Mercy Rd.
Omaha, NE 68124-2311
Phone (402) 398-6248

Other identifiers 1

IdentifierTypeStateIssuer
10025287200MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170717000121 NE Practitioner - Clinical Psychologist 9032489513 Reassigns benefits to 1 organization
I20190529002596 IA Practitioner - Clinical Psychologist 9032489513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deer Oaks Mental Health Associates PCGroup PAC ID 2264337013, 55 clinicians

Practice addresses (Care Compare)

1505 Sunset Dr
Belle Plaine, IA 52208-1301
Phone (319) 444-2500

407 S E Ave
Baxter, IA 50028-1013
Phone (641) 227-3602

5710 S 108TH St
Omaha, NE 68137-3592
Phone (402) 596-9033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3672NEMDMental Health Counselor
857NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC CurrentSince May 23, 2019 Accepting new patients

Locations

407 S East Ave
Baxter, IA 50028
Phone (641) 227-3602

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1396076451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD.",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6248",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NEWPORT AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681522164",
            "telephone_number": "402-572-2916",
            "fax_number": "402-572-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3672",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025287200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.