Individual provider Active NPI

Jessica Elsbeth Gormley

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1992007082
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1733 Issued in NE
Practice address
444 S 44TH St
Omaha, NE 68131
Phone
(402) 559-0850
Fax
(402) 559-5737
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1733 NE Primary

Addresses

Primary practice location

444 S 44TH St
Omaha, NE 68131

Mailing address

985450 Nebraska Medical Ctr
Omaha, NE 68198-5450
Phone (402) 559-0850

Other practice location 1

215 Cedar Park Blvd
Easton, PA 18042
Phone (610) 438-2662

Other names 1

  • Jessica Elsbeth Kroecker Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190830002791 NE Practitioner - Qualified Speech Language Pathologist 0244569150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Nebraska Board of RegentsGroup PAC ID 3971564279, 44 clinicians

Practice addresses (Care Compare)

6902 Pine St
Omaha, NE 68106-2855
Phone (402) 559-6418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1733NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents Speech-Language Pathologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1992007082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985450 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985450",
            "telephone_number": "402-559-0850",
            "fax_number": "402-559-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S 44TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68131",
            "telephone_number": "402-559-0850",
            "fax_number": "402-559-5737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Cedar Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "18042",
            "country_code": "US",
            "telephone_number": "610-438-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "JESSICA",
        "middle_name": "ELSBETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KROECKER",
            "middle_name": "ELSBETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 3, 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.