Provider Demographics
NPI:1043251127
Name:SCHMIDT, REX (PSYD)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16514 YORT AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2942
Mailing Address - Country:US
Mailing Address - Phone:402-933-5809
Mailing Address - Fax:
Practice Address - Street 1:984180 NEBRASKA MEDICAL CTR
Practice Address - Street 2:EMILE AT 42ND ST
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-4180
Practice Address - Country:US
Practice Address - Phone:402-559-4364
Practice Address - Fax:402-559-9107
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE514103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P82327Medicare UPIN
NE276358Medicare ID - Type Unspecified