Active NPI
Destiny Sha'Rhea Hasselmann, NP
- Family Nurse Practitioner
- Grand Island, NE
National Provider Identifier
1851030480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 114177
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.