Individual provider Active NPI

Jared Lynn Osburn

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1609552264
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2454 Issued in NE
Practice address
420 Victory Park Dr # 116
Lincoln, NE 68510-2484
Phone
(402) 680-1220
NPI assigned
Jun 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1860 NE
Clinical Social Worker 1041C0700X 2454 NE Primary

Addresses

Primary practice location

420 Victory Park Dr # 116
Lincoln, NE 68510-2484

Mailing address

420 Victory Park Dr # 116
Lincoln, NE 68510-2484
Phone (402) 489-3802

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
1860NEMDMental Health Counselor
2454NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1609552264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 VICTORY PARK DR # 116",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102484",
            "telephone_number": "402-489-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 VICTORY PARK DR # 116",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102484",
            "telephone_number": "402-680-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBURN",
        "first_name": "JARED",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1860",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "2454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.