Individual provider Active NPI

Miracle Janell Roby Mattan

  • Community Health Worker
  • Omaha, NE
National Provider Identifier
1437072899
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
ROBY-MATTAN Issued in NE
Practice address
3825 N 23Rd St
Omaha, NE 68110-1725
Phone
(402) 598-9015
NPI assigned
Aug 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X ROBY-MATTAN NE Primary

Addresses

Primary practice location

3825 N 23Rd St
Omaha, NE 68110-1725

Mailing address

11635 Arbor St Ste 110
Omaha, NE 68144-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1437072899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 ARBOR ST STE 110",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 N 23RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681101725",
            "telephone_number": "402-598-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBY MATTAN",
        "first_name": "MIRACLE",
        "middle_name": "JANELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NE",
            "license": "ROBY-MATTAN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.