Individual provider Active NPI

Jenna Wuebker, MNT

  • Nutritionist
  • Omaha, NE
National Provider Identifier
1750768669
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1161 Issued in NE
Practice address
4242 Farnam St Ste 650
Omaha, NE 68131-2813
Phone
(402) 559-8600
Fax
(402) 559-5010
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1161 NE Primary

Addresses

Primary practice location

4242 Farnam St Ste 650
Omaha, NE 68131-2813

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other names 1

  • Jenna Paseka Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515002034 NE Practitioner - Registered Dietitian Or Nutrition Professional 7012237928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1161NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince May 1, 2015 Accepting new patients

Locations

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

4242 Farnam St
Ste 650
Omaha, NE 68131
Phone (402) 502-8787

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.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1750768669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 FARNAM ST STE 650",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312813",
            "telephone_number": "402-559-8600",
            "fax_number": "402-559-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUEBKER",
        "first_name": "JENNA",
        "credential": "MNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NE",
            "license": "1161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "PASEKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.