Healthcare Provider Details

I. General information

NPI: 1992188437
Provider Name (Legal Business Name): BRETT VESSELL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

IV. Provider business mailing address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

V. Phone/Fax

Practice location:
  • Phone: 531-609-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number692090
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number415
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001276A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00435
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: