Individual provider Active NPI

Chissa Sheppard

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Omaha, NE
National Provider Identifier
1811702194
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Practice address
6806 Raymond Ave
Omaha, NE 68104-1070
Phone
(817) 716-6442
NPI assigned
Feb 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NE Primary

Addresses

Primary practice location

6806 Raymond Ave
Omaha, NE 68104-1070

Mailing address

6806 Raymond Ave
Omaha, NE 68104-1070
Phone (817) 716-6442

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

NPI Registry JSON

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1811702194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 RAYMOND AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681041070",
            "telephone_number": "817-716-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6806 RAYMOND AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681041070",
            "telephone_number": "817-716-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "CHISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NE",
            "license": null,
            "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 Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.