Active NPI
Kelly Sedor
- Physical Therapist
- Lincoln, NE
National Provider Identifier
1922455328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4039
- Practice address
- 7111 S 70TH St
Lincoln, NE 68516-3405 - Phone
- (402) 413-0525
- Fax
- (402) 413-0523
- NPI assigned
- May 16, 2016
- Last updated
- Jun 26, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1275430 | TX | |
| Physical Therapist | 225100000X | 4039 | NE | Primary |
Addresses
Primary practice location
7111 S 70TH St
Lincoln, NE 68516-3405
Mailing address
PO Box 34669
Omaha, NE 68134-0669
Phone (402) 932-6791
Other practice location 1
3201 Farnam St Ste 6110
Omaha, NE 68131-3405
Phone (402) 932-9300
Other names 1
- Kelly McCormick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Nebraska College of Medicine, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 34669
Omaha, NE 68134
Merit-based Incentive Payment System (MIPS)
- Final score
- 32.9 of 100
- Quality
- 0
- Improvement activities
- 40
- Cost
- 59.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4039 | NE | MD | Mental Health Counselor |
| 1275430 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Makovicka Harms Group, PC | Physical Therapist | Past | Accepting new patients |
| Makovicka Sylliaasen PC | Physical Therapist | 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.
-
dba Makovicka Physical Therapy
- Physical Therapist
- Papillion, NE
- NPI 1093077000
-
- Physical Therapist
- Wahoo, NE
- NPI 1770539249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1922455328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34669",
"city": "OMAHA",
"state": "NE",
"postal_code": "681340669",
"telephone_number": "402-932-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7111 S 70TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685163405",
"telephone_number": "402-413-0525",
"fax_number": "402-413-0523"
}
],
"practiceLocations": [
{
"address_1": "3201 Farnam St Ste 6110",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681313405",
"country_code": "US",
"telephone_number": "402-932-9300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEDOR",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-16",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1275430",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "4039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "MCCORMICK",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.