NPIMap

Individual provider Active NPI

Jessica K Leibhart, D.O.

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1437387180
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TEP 6122 Issued in NE
Practice address
4600 Valley Road
Suite 200
Lincoln, NE 68510-4844
Phone
(402) 483-4571
Fax
(402) 483-5079
NPI assigned
Jul 1, 2009
Last updated
Jul 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP 6122 NE Primary

Addresses

Primary practice location

4600 Valley Road
Suite 200
Lincoln, NE 68510-4844

Mailing address

4600 Valley Road
Suite 200
Lincoln, NE 68510-4844
Phone (402) 483-4571

Other identifiers 1

IdentifierTypeStateIssuer
470553011-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110620000041 NE Practitioner - Family Practice 8729266903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogallala Community HospitalGroup PAC ID 3072517523, 11 clinicians

Practice addresses (Care Compare)

2601 N Spruce St
Banner Health Clinic
Ogallala, NE 69153-2465
Phone (308) 284-3645

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.9 of 100Reported as group
Quality
68.13
Promoting interoperability
99
Improvement activities
40
Cost
69.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TEP 6122NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians West LLC CurrentSince May 29, 2020 Accepting new patients
Ogallala Community Hospital CurrentSince Feb 1, 2019 Accepting new patients
Ogallala Community Hospital Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

2601 N Spruce St
Ogallala, NE 69153
Phone (308) 284-3645

2601 N Spruce St
#A
Ogallala, NE 69153
Phone (308) 284-4011

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1437387180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 VALLEY ROAD",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104844",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY ROAD",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104844",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBHART",
        "first_name": "JESSICA",
        "middle_name": "K",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP 6122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470553011-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.