Jayne Lynn Gundrum, LMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3548 Issued in NE

Practice address

17201 Wright St
Omaha, NE 68130-2042

Phone

(402) 691-6977

Fax

(402) 445-8017

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oncology Hematology West PCGroup PAC ID 8426030024, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oncology Hematology West, PC

  • Hematology & Oncology Physician
  • Omaha, NE
  • NPI 1932178530
  Medicare reassignment Care Compare group NPD
• Oncology Hematology West, PC

  dba NCS Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Omaha, NE
  • NPI 1164833307
  NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1710979851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16098 WEBER ST",
            "city": "BENNINGTON",
            "state": "NE",
            "postal_code": "680077480",
            "telephone_number": "402-216-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17201 WRIGHT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302042",
            "telephone_number": "402-691-6977",
            "fax_number": "402-445-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDRUM",
        "first_name": "JAYNE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "PLMHP 7629",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna Gundabolu, M.D.
• Amy Sue Gunderson-Kaup
• Emily Gunderson
• Grace Jayne Gunderson
• Heather Lynne Gunderson, OT
• Ka'Nyia Gunn-Grant
• Amiya Gunn
• Camille Gunn
• Harland Joseph Gunn Sr.
• Jael Gunn

• Mental Health Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.