Active NPI
Kaleb Grandberry
- Adult Companion
- Omaha, NE
National Provider Identifier
1588503452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 1921 N 174TH St
Omaha, NE 68118-2898 - Phone
- (402) 676-7229
- NPI assigned
- Mar 26, 2026
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
1921 N 174TH St
Omaha, NE 68118-2898
Mailing address
13906 Gold Cir Ste 201
Omaha, NE 68144-2336
Phone (531) 359-8428
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774483200000",
"number": "1588503452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13906 GOLD CIR STE 201",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442336",
"telephone_number": "531-359-8428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 N 174TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182898",
"telephone_number": "402-676-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDBERRY",
"first_name": "KALEB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-26",
"last_updated": "2026-03-26",
"certification_date": "2026-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"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 Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.