Healthcare Provider Details

I. General information

NPI: 1659495844
Provider Name (Legal Business Name): JAY D HERMAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PINNACLE DR STE 105
PAPILLION NE
68046-6228
US

IV. Provider business mailing address

701 PINNACLE DR STE 105
PAPILLION NE
68046-6228
US

V. Phone/Fax

Practice location:
  • Phone: 402-505-7989
  • Fax: 402-932-8863
Mailing address:
  • Phone: 402-505-7989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1669
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: