MISS LACY RAE PHILLIPS (NPI# 1487214391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487214391 |
| Entity Type | Individual |
| Full Name | MISS LACY RAE PHILLIPS |
| Credential | PTA |
| Practice Address |
4102 Woolworth Ave Omaha NE 68105-1851 |
| Mailing Address |
4733 S Ranch Cir Blair NE 68008-6436 |
| Practice Telephone | 4024447000 |
| Mailing Telephone | 7123141681 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
1106 | NE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4102 WOOLWORTH AVE |
| City | OMAHA |
| State | NE |
| Zip Code | 68105-1851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023019718 | Douglas County Nebraska | Psychiatric Hospital | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2005-08-03 |
| 1295360014 | Julie D'agosto | Counselor | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2020-03-12 |
| 1235790551 | Meghan Greenfield | Physical Medicine & Rehabilitation | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2019-06-26 |
| 1477011294 | Patricia Ann Teeter | Nurse Practitioner | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2019-03-11 |
| 1558827980 | Robin Lee Sullivan | Counselor | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2019-02-11 |
| 1083188320 | Heidi Michelle Berthelsen | Speech-Language Pathologist | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2019-01-21 |
| 1740757327 | Katrina Dell Reifenrath | Physical Medicine & Rehabilitation | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2018-10-31 |
| 1790251841 | Stephanie Eileen Voyles | Social Worker | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2018-10-16 |
| 1225511223 | Michael A. Amenta | Nurse Practitioner | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2018-09-14 |
| 1699260943 | Teri Rachelle Conway | General Practice | 4102 Woolworth Ave, Omaha, NE 68105-1851 | 2018-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679018030 | Buoyant Family Services Counseling and Consulting LLC | Community/Behavioral Health | The Center 1941 South 42nd Street, Suite 416 S, Omaha, NE 68105 | 2016-12-21 |
| 1497104442 | Michael Lee Powell | Family Medicine | 4305 Dewey Ave, Omaha, NE 68105 | 2016-06-10 |
| 1164896361 | Kyla Haner | Counselor | 1941 S. 42nd St. Ste 514, Omaha, NE 68105 | 2015-11-25 |
| 1114359189 | Kayli Ann Bendlin | Pharmacist | 4101 Woolworth Ave.-mailstop 119, Va Medical Center-pharmacy Department, Omaha, NE 68105 | 2013-08-01 |
| 1740622372 | Ashley M Ortiz | Nurse Practitioner | 4350 Dewey Avenue, Omaha, NE 68105 | 2013-07-24 |
| 1043519655 | Mandy J Hansen | Counselor | 2101 S. 42nd Street, Omaha, NE 68105 | 2011-03-22 |
| 1851537302 | Magda Maria Blanco | Counselor | 1941 South 42nd St Suite 541, Suite 541, Omaha, NE 68105 | 2009-01-05 |
| 1609050848 | James Joseph Shehan | Internal Medicine | 4100 Woolworth, Omaha, NE 68105 | 2007-12-24 |
| 1407051477 | Cristian D Clark | Counselor | 2101 S 42nd Street, Heartland Family Service, Omaha, NE 68105 | 2007-06-19 |
| 1831312305 | Kelli Renae Welvaert | Counselor | 2101 So 42 St, Heartland Family Service, Omaha, NE 68105 | 2007-04-11 |
| Find all providers in zip 68105 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336691385 | Lorela Paronable | Physical Therapist | 3202 N 171st Ave, Omaha, NE 68116-2348 | 2016-10-25 |
| 1598018046 | Ditta Huser | Physical Therapist | 15236 Garfield St, Omaha, NE 68144-5408 | 2012-10-22 |
| 1538502364 | Marie Gruenes | Physical Therapist | 11414 West Center Road, 125, Omaha, NE 68144 | 2013-04-11 |
| 1952655888 | Michael Emery Black | Physical Therapist | 2525 S 135th Ave, Omaha, NE 68144-2424 | 2012-10-30 |
| 1619225893 | Julie Ann Gentleman | Physical Therapist | 1000 N 90th St, Suite 203, Omaha, NE 68114-2764 | 2012-08-20 |
| 1063790582 | Barbara Nell Bradley | Physical Therapist | 12856 Deauville Dr, Omaha, NE 68137-3204 | 2011-08-01 |
| 1447469960 | Teresa M. Cochran | Physical Therapist | 7100 W Center Rd, Omaha, NE 68106-2700 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356602718 | Stephanie Stevens | Physical Therapist | 12393 B Rd, Polk, NE 68654 | 2012-06-01 |
| 1740568161 | Brenda L Gawrych | Physical Therapist | 3131 N 267th Plz, Waterloo, NE 68069-5833 | 2011-08-02 |
| 1780827998 | Lance Destefano | Physical Therapist | 1622 Walnut St, Syracuse, NE 68446-7017 | 2009-04-17 |
| 1639724677 | Lydia Katherine Moore | Physical Therapist | 1702 Hillcrest Dr, Bellevue, NE 68005-3652 | 2019-08-06 |
| 1740834811 | Morgan Soucie | Physical Therapist | 926 E E St, Hastings, NE 68901-6617 | 2019-07-28 |
| 1609328392 | Jenna Rose Engelken | Physical Therapist | 610 S Polk St, Papillion, NE 68046-2548 | 2016-10-27 |
| 1013468123 | Ann Elizabeth Kastrup | Physical Therapist | 610 S Polk St, Papillion, NE 68046-2548 | 2016-10-24 |
| 1023470630 | Christine Montes | Physical Therapist | 450 E 23rd St, Fremont, NE 68025-2303 | 2016-03-23 |
| 1285042820 | Hannah Behrens | Physical Therapist | 1804 Hillcrest Dr, Bellevue, NE 68005-3663 | 2014-07-28 |
| 1710320502 | Nicholas Matthew Breunig | Physical Therapist | 1760 County Road J, Wahoo, NE 68066-4152 | 2013-04-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.