Individual provider Active NPI

Garrett Nathan, MS-CCC-SLP

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1619427457
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1970 Issued in NE
Practice address
13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124
Phone
(402) 330-3211
Fax
(402) 330-5970
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1970 NE Primary

Addresses

Primary practice location

13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124

Mailing address

13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124
Phone (402) 330-3211

Other identifiers 1

IdentifierTypeStateIssuer
47065477700MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170707001978 NE Practitioner - Qualified Speech Language Pathologist 6901175835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents CurrentSince Oct 1, 2021 Accepting new patients
University of Nebraska Board of Regents CurrentSince Oct 1, 2021 Accepting new patients
Makovicka Harms Group PC PastSince Jun 15, 2017 Accepting new patients
University of Nebraska Board of Regents Speech-Language Pathologist Past Accepting new patients

Locations

6902 Pine St
Omaha, NE 68106
Phone (402) 559-6418

985450 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-6408

444 S 44th St
Omaha, NE 68131
Phone (402) 559-3563

Organizations & group practices 4

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1619427457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13336 INDUSTRIAL RD",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371124",
            "telephone_number": "402-330-3211",
            "fax_number": "402-330-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13336 INDUSTRIAL RD",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371124",
            "telephone_number": "402-330-3211",
            "fax_number": "402-330-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "GARRETT",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477700",
            "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 Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.