Active NPI
Kaven Medlock
- Chore Provider
- Omaha, NE
National Provider Identifier
1700674652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chore Provider
- Practice address
- 319 S 17TH St Ste 418
Omaha, NE 68102-2016 - Phone
- (402) 999-9063
- NPI assigned
- Apr 29, 2025
- 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 |
|---|---|---|---|---|
| Chore Provider | 372500000X | NE | Primary |
Addresses
Primary practice location
319 S 17TH St Ste 418
Omaha, NE 68102-2016
Mailing address
5001 Spencer St
Omaha, NE 68104-3564
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Xtrakare LLC | Current | Accepting new patients |
Locations
319 S 17th St
Ste 418
Omaha, NE 68102
Phone (402) 819-8227
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.
-
- In Home Supportive Care Agency
- Omaha, NE
- NPI 1215758966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1700674652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 SPENCER ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681043564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 S 17TH ST STE 418",
"city": "OMAHA",
"state": "NE",
"postal_code": "681022016",
"telephone_number": "402-999-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDLOCK",
"first_name": "KAVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-29",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": "NE",
"license": null,
"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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.