Active NPI
Joe Chavis
- Addiction (Substance Use Disorder) Counselor
- Omaha, NE
National Provider Identifier
1699932350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 631
- Practice address
- 12165 W Center Rd
Suite 70
Omaha, NE 68144-3962 - Phone
- (402) 697-3923
- Fax
- (402) 697-3924
- NPI assigned
- May 20, 2008
- Last updated
- May 20, 2008
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 631 | NE | Primary |
Addresses
Primary practice location
12165 W Center Rd
Suite 70
Omaha, NE 68144-3962
Mailing address
12165 W Center Rd
Suite 70
Omaha, NE 68144-3962
Phone (402) 697-3923
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025332900 | Medicaid | NE | |
| 47082303526 | Medicaid | NE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 631 | NE | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1699932350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12165 W CENTER RD",
"address_2": "SUITE 70",
"city": "OMAHA",
"state": "NE",
"postal_code": "681443962",
"telephone_number": "402-697-3923",
"fax_number": "402-697-3924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12165 W CENTER RD",
"address_2": "SUITE 70",
"city": "OMAHA",
"state": "NE",
"postal_code": "681443962",
"telephone_number": "402-697-3923",
"fax_number": "402-697-3924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "JOE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-20",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "631",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025332900",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47082303526",
"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 May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.