Active NPI
Janis Kay Andersen
- Registered Nurse
- Omaha, NE
National Provider Identifier
1558469114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 107712
- Practice address
- 1400 Douglas St Stop 0030
Omaha, NE 68179-1001 - Phone
- (402) 544-3697
- Fax
- (402) 501-0475
- NPI assigned
- Sep 20, 2006
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 107712 | IA | Primary |
Addresses
Primary practice location
1400 Douglas St Stop 0030
Omaha, NE 68179-1001
Mailing address
63 Crestwood Dr
Council Bluffs, IA 51503-0201
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 |
|---|---|---|---|
| 107712 | IA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558469114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 CRESTWOOD DR",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515030201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 DOUGLAS ST STOP 0030",
"city": "OMAHA",
"state": "NE",
"postal_code": "681791001",
"telephone_number": "402-544-3697",
"fax_number": "402-501-0475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "JANIS",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "107712",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.