NPIMap

Organization Active NPI

Peace Practice Psychology Center PC

  • Preferred Provider Organization
  • Lincoln, NE
National Provider Identifier
1417227240
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
PEACE PRACTICE PSYCHOLOGY CENTER PC
Practice address
1919 S 40TH St
Ste 111
Lincoln, NE 68506-5243
Phone
(402) 488-3037
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Susie Romanik
Title
Billing Specialist
Phone
(402) 496-9966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

1919 S 40TH St
Ste 111
Lincoln, NE 68506-5243

Mailing address

1919 S 40TH St
Ste 111
Lincoln, NE 68506-5243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131109000370 NE Part B Supplier - Clinic/Group Practice 5698900173 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1417227240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "STE 111",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "STE 111",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065243",
            "telephone_number": "402-488-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE PRACTICE PSYCHOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "ROMANIK",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "402-496-9966"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "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 Jan 10, 2012; 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.