Active NPI
Jessica Brazda, LPN
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1437826781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24451
- Practice address
- 5905 O St
Lincoln, NE 68510-2235 - Phone
- (402) 436-1655
- NPI assigned
- Aug 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 24451 | NE | Primary |
Addresses
Primary practice location
5905 O St
Lincoln, NE 68510-2235
Mailing address
6143 NW 11TH St
Lincoln, NE 68521-3717
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24451 | NE | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1437826781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6143 NW 11TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685213717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 O ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102235",
"telephone_number": "402-436-1655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZDA",
"first_name": "JESSICA",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-25",
"last_updated": "2021-08-25",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "24451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.