Active NPI
Douglas Michael Neville
- Occupational Therapy Assistant
- Lincoln, NE
National Provider Identifier
1447762208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1013
- Practice address
- 8601 Firethorn Lane
Lincoln, NE 68520 - Phone
- (402) 682-6825
- NPI assigned
- Nov 1, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1013 | NE | Primary |
Addresses
Primary practice location
8601 Firethorn Lane
Lincoln, NE 68520
Mailing address
2901 Mark Ave
Lincoln, NE 68502-5938
Phone (402) 580-2021
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 |
|---|---|---|---|
| 1013 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509494400000",
"number": "1447762208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 MARK AVE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685025938",
"telephone_number": "402-580-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8601 FIRETHORN LANE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68520",
"telephone_number": "402-682-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVILLE",
"first_name": "DOUGLAS",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-01",
"last_updated": "2017-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NE",
"license": "1013",
"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 Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.