Individual provider Active NPI

Destiny Sha'Rhea Hasselmann, NP

  • Family Nurse Practitioner
  • Grand Island, NE
National Provider Identifier
1851030480
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114177 Issued in NE
Practice address
2201 N Broadwell Ave
Grand Island, NE 68803-2153
Phone
(308) 382-3660
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 114177 NE Primary

Addresses

Primary practice location

2201 N Broadwell Ave
Grand Island, NE 68803-2153

Mailing address

2655 W Wildwood Dr
Grand Island, NE 68801-9619
Phone (308) 380-3243

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
I20220822002713 NE Order and Referring Only - Nurse Practitioner 6608259726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1851030480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 W WILDWOOD DR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688019619",
            "telephone_number": "308-380-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N BROADWELL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032153",
            "telephone_number": "308-382-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSELMANN",
        "first_name": "DESTINY",
        "middle_name": "SHA'RHEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "114177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.