Individual provider Active NPI

Jessica Rupp, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1811673650
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
114845 Issued in NE
Practice address
4400 Emile St
Omaha, NE 68198-0600
Phone
(402) 672-0180
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 114845 NE Primary

Addresses

Primary practice location

4400 Emile St
Omaha, NE 68198-0600

Mailing address

705 N 82ND PLZ Apt 12
Omaha, NE 68114-3587

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817001856 NE Practitioner - Nurse Practitioner 4284096504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madonna Rehabilitation HospitalGroup PAC ID 0446164081, 92 clinicians
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

5401 S St
Lincoln, NE 68506-2150
Phone (402) 489-7102

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114845NEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madonna Rehabilitation Hospital CurrentSince Sep 15, 2023 Accepting new patients
Unmc Physicians CurrentSince Jul 27, 2023 Accepting new patients

Locations

5401 South St
Lincoln, NE 68506
Phone (402) 413-3000

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

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

4400 Emile St
Omaha, NE 68198
Phone (402) 559-4500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1811673650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N 82ND PLZ APT 12",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EMILE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980600",
            "telephone_number": "402-672-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "JESSICA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NE",
            "license": "114845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.