Individual provider Active NPI

Larisa Rother

  • Behavior Technician
  • Omaha, NE
National Provider Identifier
1558077784
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-255714 Issued in NE
Practice address
9802 Nicholas St Ste 395
Omaha, NE 68114-2168
Phone
(402) 252-1363
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
RBT-23-255714NEMDBehavior Technician

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-255714 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

9802 Nicholas St Ste 395
Omaha, NE 68114-2168

Mailing address

311 Boulevard of Americas Ste 304
Lakewood, NJ 08701-4788
Phone (402) 252-1363

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2023.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1558077784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 BOULEVARD OF AMERICAS STE 304",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014788",
            "telephone_number": "402-252-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9802 NICHOLAS ST STE 395",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142168",
            "telephone_number": "402-252-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHER",
        "first_name": "LARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NE",
            "license": "RBT-23-255714",
            "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 Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.