Individual provider Active NPI

Jodi Gentleman

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1992050736
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1552 Issued in NE
Practice address
42 ND Dewey St
Omaha, NE 68198-1023
Phone
(402) 552-6007
Fax
(402) 552-6225
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 896 NE
Mental Health Counselor 101YM0800X 1552 NE Primary

Addresses

Primary practice location

42 ND Dewey St
Omaha, NE 68198-1023

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Phone (402) 559-6195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140416001247 NE Practitioner - Clinical Social Worker 3375775885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7909 L St
Omaha, NE 68127-1725
Phone (402) 997-0008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
896NEMDAddiction (Substance Use Disorder) Counselor
1552NEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Apr 4, 2016 Accepting new patients

Locations

42nd Dewey St
Omaha, NE 68198
Phone (402) 552-6244

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1992050736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 ND DEWEY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981023",
            "telephone_number": "402-552-6007",
            "fax_number": "402-552-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTLEMAN",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "896",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.