Active NPI
Jeffrey J David, M.D.
- Pediatrics Physician
- Lincoln, NE
National Provider Identifier
1669400487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 16994
- Practice address
- 4501 S 70TH St
Suite 110
Lincoln, NE 68516-4282 - Phone
- (402) 489-3834
- Fax
- (402) 489-5049
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 16994 | NE | Primary |
Addresses
Primary practice location
4501 S 70TH St
Suite 110
Lincoln, NE 68516-4282
Mailing address
4501 S 70TH St
Suite 110
Lincoln, NE 68516-4282
Phone (402) 489-3834
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47049487112 | Medicaid | NE | |
| 06420 | Other | NE | BLUE CROSS BLUE SHIELD |
| 12 00029 | Other | NE | UNITED HEALTHCARE |
| 2536 | 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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16994 | NE | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1669400487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 S 70TH ST",
"address_2": "SUITE 110",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164282",
"telephone_number": "402-489-3834",
"fax_number": "402-489-5049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 S 70TH ST",
"address_2": "SUITE 110",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164282",
"telephone_number": "402-489-3834",
"fax_number": "402-489-5049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "JEFFREY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "16994",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47049487112",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "06420",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "12 00029",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "2536",
"state": "NE"
}
],
"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 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.