Individual provider Active NPI

Mollie M Eckhardt, MA, CCC-SLP

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1649578139
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1258 Issued in NE
Practice address
8303 Dodge St Ste 304
Omaha, NE 68114-4108
Phone
(402) 354-5048
Fax
(402) 354-2585
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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 1258 NE Primary

Addresses

Primary practice location

8303 Dodge St Ste 304
Omaha, NE 68114-4108

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 2

IdentifierTypeStateIssuer
10026075400MedicaidNE
1649578139MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171207002031 NE Practitioner - Qualified Speech Language Pathologist 9335406842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

8303 Dodge St
Suite 304
Omaha, NE 68114-4108
Phone (402) 354-5048

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1258NEMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital CurrentSince Jan 18, 2017 Accepting new patients

Locations

8303 Dodge St
Ste LL6
Omaha, NE 68114
Phone (402) 354-4104

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

8303 Dodge St
Ste 304
Omaha, NE 68114
Phone (402) 354-4104

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1649578139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-216-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST STE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-5048",
            "fax_number": "402-354-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHARDT",
        "first_name": "MOLLIE",
        "middle_name": "M",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026075400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649578139",
            "state": "IA"
        }
    ],
    "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 Feb 13, 2018; 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.