Active NPI
Kelly Djernes, PT, DPT
- Physical Therapist
- Omaha, NE
National Provider Identifier
1477095313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3128
- Practice address
- 2510 S 140TH St
Omaha, NE 68144 - Phone
- (402) 618-3320
- Fax
- (402) 913-3102
- NPI assigned
- Nov 9, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3128 | NE | Primary |
Addresses
Primary practice location
2510 S 140TH St
Omaha, NE 68144
Mailing address
2510 S 140TH St
Omaha, NE 68144
Phone (402) 618-3320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170320000966 | NE | Practitioner - Physical Therapist in Private Practice | 1254612435 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3128 | NE | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1477095313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 S 140TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "68144",
"telephone_number": "402-618-3320",
"fax_number": "402-913-3102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 S 140TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "68144",
"telephone_number": "402-618-3320",
"fax_number": "402-913-3102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DJERNES",
"first_name": "KELLY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-09",
"last_updated": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3128",
"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 Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.