NPIMap

Organization Active NPI

Renewed Health Outreach and Psychotherapy LLC

  • Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1619869419
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RENEWED HEALTH OUTREACH AND PSYCHOTHERAPY LLC
Practice address
3510 Village Dr Ste B
Lincoln, NE 68516-5363
Phone
(402) 937-1920
Fax
(402) 937-1955
NPI assigned
Jul 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Grant Papenhagen
Title
HR Manager
Phone
(402) 937-1920

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

3510 Village Dr Ste B
Lincoln, NE 68516-5363

Mailing address

3510 Village Dr Ste B
Lincoln, NE 68516-5363
Phone (402) 937-1920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251113000226 NE Part B Supplier - Clinic/Group Practice 4880185347 Receives reassigned benefits from 4 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1619869419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 VILLAGE DR STE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165363",
            "telephone_number": "402-937-1920",
            "fax_number": "402-937-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 VILLAGE DR STE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165363",
            "telephone_number": "402-937-1920",
            "fax_number": "402-937-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED HEALTH OUTREACH AND PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "PAPENHAGEN",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "HR MANAGER",
        "authorized_official_telephone_number": "402-937-1920"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "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 Oct 21, 2025; 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.