Active NPI
Agnes Mariann Stairs, PH.D.
- Clinical Psychologist
- Omaha, NE
National Provider Identifier
1881149631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 785
- Practice address
- Specialty Services Pavilion RM 5014
984185 Nebraska Medical Center
Omaha, NE 68198-4185 - Phone
- (402) 559-5031
- Fax
- (402) 559-9592
- NPI assigned
- Aug 22, 2016
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 785 | NE | Primary |
Addresses
Primary practice location
Specialty Services Pavilion RM 5014
984185 Nebraska Medical Center
Omaha, NE 68198-4185
Mailing address
536 N 74TH Ave
Omaha, NE 68114-3102
Phone (402) 660-7143
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 785 | NE | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1881149631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 N 74TH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681143102",
"telephone_number": "402-660-7143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SPECIALTY SERVICES PAVILION RM 5014",
"address_2": "984185 NEBRASKA MEDICAL CENTER",
"city": "OMAHA",
"state": "NE",
"postal_code": "681984185",
"telephone_number": "402-559-5031",
"fax_number": "402-559-9592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAIRS",
"first_name": "AGNES",
"middle_name": "MARIANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NE",
"license": "785",
"primary": true
}
],
"identifiers": [],
"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 Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.