Individual provider Active NPI

Jumoke Omojola

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1417334756
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1374 Issued in NE
Practice address
4318 N 136TH St
Omaha, NE 68164-5091
Phone
(402) 981-6624
NPI assigned
May 6, 2015
Last updated
May 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1581 NE
Clinical Social Worker 1041C0700X 1374 NE Primary

Addresses

Primary practice location

4318 N 136TH St
Omaha, NE 68164-5091

Mailing address

4318 N 136TH St
Omaha, NE 68164-5091
Phone (402) 981-6624

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
I20150804003322 NE Practitioner - Clinical Social Worker 9739493859 Reassigns benefits to 2 organizations
Practice locations: Omaha, NE

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Embrace Mental Wellness LLCGroup PAC ID 8527394410, 2 clinicians

Practice addresses (Care Compare)

8031 W Ctr Rd
Suite 204
Omaha, NE 68124-3134
Phone (402) 281-6881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1581NEMDAddiction (Substance Use Disorder) Counselor
1374NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace Mental Wellness LLC CurrentSince Jun 22, 2019 Accepting new patients
Octave Therapy Licensed Clinical Social Work Inc Clinical Current Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince May 14, 2018 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince May 14, 2018 Accepting new patients

Locations

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

8031 W Center Rd
Ste 204
Omaha, NE 68124
Phone (402) 403-9469

8031 W Center Rd
Ste 307
Omaha, NE 68124
Phone (402) 312-4179

Organizations & group practices 4

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1417334756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 N 136TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681645091",
            "telephone_number": "402-981-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 N 136TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681645091",
            "telephone_number": "402-981-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOJOLA",
        "first_name": "JUMOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1581",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.