Individual provider Active NPI

Danny J Kissinger, O.T.

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1598727885
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1635 Issued in NE
Practice address
2727 S 144TH St # 142
Omaha, NE 68144-5225
Phone
(402) 559-8000
Fax
(402) 596-8746
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 3241 AZ
Occupational Therapist 225X00000X 3241 AZ
Occupational Therapist 225X00000X 1635 NE Primary

Addresses

Primary practice location

2727 S 144TH St # 142
Omaha, NE 68144-5225

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-6195

Other identifiers 2

IdentifierTypeStateIssuer
854324MedicaidAZ
47065477702MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130103000408 NE Practitioner - Occupational Therapist in Private Practice 5597830422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1635NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Procare3, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Spooner Phoenix Physical Therapy, Inc. Past Accepting new patients
KC's Physical Therapy LLC Past Accepting new patients

Locations

4614 S 132nd St
Omaha, NE 68137
Phone (402) 330-3211

545 Fortune Dr
Ste 100
Papillion, NE 68046
Phone (402) 991-0333

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1598727885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 S 144TH ST # 142",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445225",
            "telephone_number": "402-559-8000",
            "fax_number": "402-596-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSINGER",
        "first_name": "DANNY",
        "middle_name": "J",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "AZ",
            "license": "3241",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3241",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "854324",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477702",
            "state": "NE"
        }
    ],
    "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 Apr 6, 2016; 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.

Verify at the official NPI Registry.