Individual provider Active NPI

Therese A Hennessy, DO

  • Pediatrics Physician
  • Omaha, NE
National Provider Identifier
1720028699
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
238 Issued in NE
Practice address
4920 S 30TH St
Ste 103
Omaha, NE 68107
Phone
(402) 734-4110
Fax
(402) 991-5642
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 238 NE Primary

Addresses

Primary practice location

4920 S 30TH St
Ste 103
Omaha, NE 68107

Mailing address

4920 S 30TH St
Ste 103
Omaha, NE 68107
Phone (402) 734-4110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080718000068 NE Practitioner - Family Practice 3274508239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
238NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. CurrentSince Mar 1, 2007 Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
All Care Health Center PastSince Jan 17, 2022 Accepting new patients

Locations

2207 Georgia Ave
Bellevue, NE 68005
Phone (402) 502-8855

4920 S 30th St
Ste 103
Omaha, NE 68107

4229 N 90th St
Omaha, NE 68134
Phone (402) 401-6000

122 S 6th St
Plattsmouth, NE 68048
Phone (402) 296-2345

Interoperability endpoints

  • Direct secure messaging: therese.hennessy.p1@direct.oneworldomaha.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1720028699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68107",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST",
            "address_2": "STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68107",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "THERESE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.