Active NPI
Jerry Easterday, M.D.
- Psychiatry Physician
- Omaha, NE
National Provider Identifier
1821275595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 36076
- Practice address
- 9947 Broadmoor Rd
Omaha, NE 68114-4926 - Phone
- (402) 639-3050
- Fax
- (402) 398-0152
- NPI assigned
- Jan 24, 2008
- Last updated
- Jan 24, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 36076 | MO | Primary |
| Psychiatry Physician | 2084P0800X | 15948 | NE |
Addresses
Primary practice location
9947 Broadmoor Rd
Omaha, NE 68114-4926
Mailing address
9947 Broadmoor Rd
Omaha, NE 68114-4926
Phone (402) 639-3050
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36076 | MO | MD | Psychiatry Physician |
| 15948 | NE | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201132800000",
"number": "1821275595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9947 BROADMOOR RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681144926",
"telephone_number": "402-639-3050",
"fax_number": "402-398-0152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9947 BROADMOOR RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681144926",
"telephone_number": "402-639-3050",
"fax_number": "402-398-0152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTERDAY",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-24",
"last_updated": "2008-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "36076",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NE",
"license": "15948",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
- Raelynn Eason
- East & West Physical Therapy LLC
- Camille Elizabeth Easter
- Gwendolyn A. Easter
- Lisa Easter
- Stephanie Deshaun Easterling
- Eastern Ambulance Service Inc (Rural/Metro Ambulance)
- Eastern Horizon Counseling Services,Inc.
- Eastern Nebraska Community Action Partnership
- Eastern Nebraska Human Services Agency (S.Douglas)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.