Individual provider Active NPI

Nicole Wragge, MOT/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1629520481
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1681 Issued in NE
Practice address
2732 N 123Rd Cir
Omaha, NE 68160
Phone
(402) 990-5084
NPI assigned
Oct 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1681 NE Primary

Addresses

Primary practice location

2732 N 123Rd Cir
Omaha, NE 68160

Mailing address

2732 N 123Rd Cir
Omaha, NE 68164-2504

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108004419 NE Practitioner - Occupational Therapist in Private Practice 7416308077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Neurological Therapy and Wellness Center, LLCGroup PAC ID 2860883675, 9 clinicians

Practice addresses (Care Compare)

2546 River Rd Dr
BLDG C
Waterloo, NE 68069-2067
Phone (531) 444-8945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Neurological Therapy and Wellness Center LLC CurrentSince Nov 21, 2023 Accepting new patients

Locations

2546 River Road Dr
Bldg C
Waterloo, NE 68069
Phone (402) 319-0801

Organizations & group practices 1

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1629520481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 N 123RD CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681642504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 N 123RD CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68160",
            "telephone_number": "402-990-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAGGE",
        "first_name": "NICOLE",
        "credential": "MOT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1681",
            "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 Oct 27, 2016; 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.