Active NPI
Heather Kozak
- Licensed Practical Nurse
- Bennington, NE
National Provider Identifier
1821898248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 23970
- Practice address
- 12135 Elmwood Dr
Bennington, NE 68007-1714 - Phone
- (402) 817-4959
- NPI assigned
- Mar 14, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 23970 | NE | Primary |
Addresses
Primary practice location
12135 Elmwood Dr
Bennington, NE 68007-1714
Mailing address
220 Oakcreek Dr
Lincoln, NE 68528-1587
Phone (402) 817-4959
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 |
|---|---|---|---|
| 23970 | NE | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741910400000",
"number": "1821898248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 OAKCREEK DR",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685281587",
"telephone_number": "402-817-4959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12135 ELMWOOD DR",
"city": "BENNINGTON",
"state": "NE",
"postal_code": "680071714",
"telephone_number": "402-817-4959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZAK",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-14",
"last_updated": "2025-03-14",
"certification_date": "2025-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NE",
"license": "23970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bennington, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.