Provider Demographics
NPI:1366463994
Name:TRIGGS, JODI I (DO)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:I
Last Name:TRIGGS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:I
Other - Last Name:CLEMENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:STE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:555 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2462
Practice Address - Country:US
Practice Address - Phone:402-219-8747
Practice Address - Fax:402-219-8748
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0402431OtherUHC
NE470780857 23Medicaid
NE03010OtherBCBS
IA0719161Medicaid
NE250622OtherMIDLAND'S CHOICE
KS200378090AMedicaid
NE470780857 23Medicaid
280405Medicare PIN