Active NPI
Cody Havermann
- Behavior Analyst
- Omaha, NE
National Provider Identifier
1790384345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1299 Farnam St Ste 300
Omaha, NE 68102-1857 - Phone
- (402) 969-6633
- NPI assigned
- Oct 23, 2020
- Last updated
- Aug 24, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NU | Primary | |
| Behavior Technician | 106S00000X | RBT-20-132455 | SD |
Addresses
Primary practice location
1299 Farnam St Ste 300
Omaha, NE 68102-1857
Mailing address
508 James PL
Yankton, SD 57078-1830
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-132455 | SD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1790384345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 JAMES PL",
"city": "YANKTON",
"state": "SD",
"postal_code": "570781830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1299 FARNAM ST STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681021857",
"telephone_number": "402-969-6633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVERMANN",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-23",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SD",
"license": "RBT-20-132455",
"primary": false
}
],
"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 Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.