Individual provider Active NPI

Jack Robert Cosgrove, OTD, OTR/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1720998255
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3160 Issued in NE
Practice address
17500 Burke St
Omaha, NE 68118-2244
Phone
(402) 401-3900
NPI assigned
Sep 8, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3160 NE Primary

Addresses

Primary practice location

17500 Burke St
Omaha, NE 68118-2244

Mailing address

5401 South St
Lincoln, NE 68506-2150
Phone (402) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1720998255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 BURKE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182244",
            "telephone_number": "402-401-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSGROVE",
        "first_name": "JACK",
        "middle_name": "ROBERT",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "3160",
            "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 Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.