Individual provider Active NPI

Pamela Jean Klaebisch, OTR/L, CLT

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1871508341
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
864 Issued in NE
Practice address
7808 Davenport St
Omaha, NE 68114
Phone
(402) 393-2294
Fax
(402) 393-2754
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 864 NE Primary
Physical Rehabilitation Occupational Therapist 225XP0019X 864 NE

Addresses

Primary practice location

7808 Davenport St
Omaha, NE 68114

Mailing address

7808 Davenport St
Omaha, NE 68114
Phone (402) 393-2294

Other identifiers 5

IdentifierTypeStateIssuer
02425OtherNEBCBS NEBRASKA
P00838601OtherNERR MEDICARE
10025436800MedicaidNE
DF6645OtherNERR MEDICARE
02056OtherNEBCBS NEBRASKA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061009000123 NE Practitioner - Occupational Therapist in Private Practice 6507862943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7808 Davenport St
Omaha, NE 68114-3629
Phone (402) 393-2294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
864NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Rehab LLC CurrentSince Jan 16, 2010 Accepting new patients
Community Rehab, Inc CurrentSince Jan 16, 2010 Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients

Locations

1408 Veterans Dr
Ste 102
Elkhorn, NE 68022
Phone (402) 289-3288

410 E 22nd St
Fremont, NE 68025
Phone (402) 721-3908

Organizations & group practices 6

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1871508341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-393-2294",
            "fax_number": "402-393-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-393-2294",
            "fax_number": "402-393-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAEBISCH",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "864",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NE",
            "license": "864",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NEBRASKA",
            "identifier": "02425",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00838601",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025436800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF6645",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NEBRASKA",
            "identifier": "02056",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.