Active NPI
Marjorie A Padula, PH.D.
- Clinical Neuropsychologist
- Omaha, NE
National Provider Identifier
1649310467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 400
- Practice address
- 11330 Q St
Omaha, NE 68137-3679 - Phone
- (402) 955-2884
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 400 | NE | |
| Adult Development & Aging Psychologist | 103TA0700X | 400 | NE | |
| Family Psychologist | 103TF0000X | 400 | NE | |
| Clinical Neuropsychologist | 103G00000X | 400 | NE | Primary |
| Clinical Psychologist | 103TC0700X | 400 | NE | |
| Counseling Psychologist | 103TC1900X | 400 | NE | |
| Forensic Psychologist | 103TF0200X | 400 | NE | |
| Rehabilitation Psychologist | 103TR0400X | 400 | NE | |
| Health Service Psychologist | 103TH0100X | 400 | NE |
Addresses
Primary practice location
11330 Q St
Omaha, NE 68137-3679
Mailing address
PO Box 27034
Omaha, NE 68127-0034
Phone (402) 955-2884
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10024948300 | Medicaid | NE | |
| 08209 | Other | NE | BLUE CROSS BLUE SHIELD |
| 47085691100 | Medicaid | NE | |
| 8180 | Other | NE | MIDLANDS CHOICE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400 | NE | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Medical Center | Past | Accepting new patients |
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.
-
dba Clarkson Family Medicine - Nebraska Medicine
- Family Medicine Physician
- Omaha, NE
- NPI 1891721395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349136000000",
"number": "1649310467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27034",
"city": "OMAHA",
"state": "NE",
"postal_code": "681270034",
"telephone_number": "402-955-2884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11330 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373679",
"telephone_number": "402-955-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADULA",
"first_name": "MARJORIE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2012-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NE",
"license": "400",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "NE",
"license": "400",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "NE",
"license": "400",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10024948300",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "08209",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47085691100",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "8180",
"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 Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.