Individual provider Active NPI

Janette Elaine Thomas Stallings, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, NE
National Provider Identifier
1871092353
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
112405 Issued in NE
Practice address
1620 Wilshire Dr Ste 222
Bellevue, NE 68005-6600
Phone
(402) 502-1931
Fax
(402) 999-4812
NPI assigned
Feb 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 112405 NE Primary

Addresses

Primary practice location

1620 Wilshire Dr Ste 222
Bellevue, NE 68005-6600

Mailing address

PO Box 1420
Bellevue, NE 68005-1420
Phone (402) 502-1931

Other identifiers 1

IdentifierTypeStateIssuer
16900MedicaidNE

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
I20180321000264 NE Practitioner - Nurse Practitioner 0547522013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1620 Wilshire Dr
Suite 220
Bellevue, NE 68005-6600
Phone (402) 502-1931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112405NEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Mental Health, LLC CurrentSince Jan 1, 2019 Accepting new patients
Great Plains Mental Health Associates LLC Psychiatric/Mental Health CurrentSince Apr 1, 2018 Accepting new patients

Locations

1620 Wilshire Dr
Ste 222
Bellevue, NE 68005
Phone (402) 502-1931

1620 Wilshire Dr
Ste 220
Bellevue, NE 68005
Phone (402) 502-1931

4610 S 133rd St
Ste 109
Omaha, NE 68137
Phone (402) 614-0010

706 N 129th St
Ste 111
Omaha, NE 68154
Phone (402) 671-2710

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21060/brand/4/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1871092353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1420",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680051420",
            "telephone_number": "402-502-1931",
            "fax_number": "402-999-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 WILSHIRE DR STE 222",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680056600",
            "telephone_number": "402-502-1931",
            "fax_number": "402-999-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "JANETTE",
        "middle_name": "ELAINE THOMAS",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "112405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.