Individual provider Active NPI

Kelly M Houfek, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1417380486
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
111568 Issued in NE
Practice address
4610 S 133Rd St Ste 109
Omaha, NE 68137-1133
Phone
(402) 614-0010
Fax
(402) 614-0090
NPI assigned
Aug 14, 2013
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111568 NE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 111568 NE Primary

Addresses

Primary practice location

4610 S 133Rd St Ste 109
Omaha, NE 68137-1133

Mailing address

4610 S 133Rd St Ste 109
Omaha, NE 68137-1133
Phone (402) 614-0010

Other names 1

  • Kelly M Schroeder Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114001087 NE Practitioner - Nurse Practitioner 1557597838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains Mental Health Associates LLCGroup PAC ID 9537422332, 13 clinicians

Practice addresses (Care Compare)

4610 S 133Rd St
Suite 109
Omaha, NE 68137-1333
Phone (402) 614-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Plains Mental Health Associates LLC Psychiatric/Mental Health CurrentSince May 1, 2018 Accepting new patients

Locations

4610 S 133rd St
Ste 109
Omaha, NE 68137
Phone (402) 614-0010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21060/brand/4/csg/1/fhir/r4

Organizations & group practices 2

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1417380486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 S 133RD ST STE 109",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371133",
            "telephone_number": "402-614-0010",
            "fax_number": "402-614-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 S 133RD ST STE 109",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371133",
            "telephone_number": "402-614-0010",
            "fax_number": "402-614-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUFEK",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111568",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "111568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SCHROEDER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.