Individual provider Active NPI

Jacob Layton Andrus, DO

  • Student in an Organized Health Care Education/Training Program
  • Offutt Afb, NE
National Provider Identifier
1437044005
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2501 Capehart Rd
Offutt Afb, NE 68113-1043
Phone
(402) 294-2056
NPI assigned
Jun 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2501 Capehart Rd
Offutt Afb, NE 68113-1043

Mailing address

2501 Capehart Rd
Offutt Afb, NE 68113-1043

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251018000126 NE Order and Referring Only - Family PracticePractitioner - Family Practice 3678061090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10247NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1437044005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-294-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "JACOB",
        "middle_name": "LAYTON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Offutt Afb, NE

Sources for this page

Verify at the official NPI Registry.