Active NPI
Shaylee Dirks, PTA
- Physical Therapy Assistant
- Gretna, NE
National Provider Identifier
1881039618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1179
- Practice address
- 720 N Highway 6
Gretna, NE 68028-7950 - Phone
- (402) 332-3773
- NPI assigned
- May 7, 2013
- Last updated
- Nov 5, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1179 | NE | Primary |
Addresses
Primary practice location
720 N Highway 6
Gretna, NE 68028-7950
Mailing address
720 N Highway 6
Gretna, NE 68028-7950
Phone (402) 332-3773
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 |
|---|---|---|---|
| 1179 | NE | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Makovicka Harms Group PC | Past | Accepting new patients | |
| Gretna Physical Therapy, PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Gretna, NE
- NPI 1679696199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1881039618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 N HIGHWAY 6",
"city": "GRETNA",
"state": "NE",
"postal_code": "680287950",
"telephone_number": "402-332-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 N HIGHWAY 6",
"city": "GRETNA",
"state": "NE",
"postal_code": "680287950",
"telephone_number": "402-332-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRKS",
"first_name": "SHAYLEE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-07",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NE",
"license": "1179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gretna, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.