Individual provider Active NPI

Barbara K. Clinkenbeard, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, NE
National Provider Identifier
1497761415
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
110789 Issued in NE
Practice address
4308 Victoria Ave
Bellevue, NE 68123-4183
Phone
(402) 953-9610
NPI assigned
Jul 31, 2006
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 110789 NE Primary

Addresses

Primary practice location

4308 Victoria Ave
Bellevue, NE 68123-4183

Mailing address

4308 Victoria Ave
Bellevue, NE 68123-4183
Phone (402) 953-9610

Other identifiers 1

IdentifierTypeStateIssuer
10026806600MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000217 NE Practitioner - Nurse Practitioner 4486661170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Creighton University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4308 Victoria Ave
Bellevue, NE 68123-4183
Phone (402) 804-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2305WIMDAthletic Trainer
110789NEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Circle Counseling LLC CurrentSince Nov 1, 2019 Accepting new patients
Creighton University Past Accepting new patients
John F. Troy, Psy.D., P.C. Past Accepting new patients
Creighton University Past Accepting new patients

Locations

13911 Gold Cir
Ste 210
Omaha, NE 68144
Phone (402) 333-6950

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1497761415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 VICTORIA AVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681234183",
            "telephone_number": "402-953-9610",
            "fax_number": "402-333-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 VICTORIA AVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681234183",
            "telephone_number": "402-953-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINKENBEARD",
        "first_name": "BARBARA",
        "middle_name": "K.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "110789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026806600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.