KERRY L TAKEDA (APRN) – Primary Care Nurse Practitioner, NPI 1811681497

KERRY L TAKEDA (APRN) is a healthcare provider. based in La vista, Nebraska. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 114804 (NE). The NPI Number for KERRY L TAKEDA (APRN) is 1811681497

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KERRY L TAKEDA (APRN)
NPI
1811681497
Phone
(402) 779-7207
Address
8074 S 84TH ST
Enumeration Date
6 June 2023
Last Update Date
13 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024447000
Graduation Year
2022 (4 years ago)
PAC ID
8921468430
Group Practice PAC ID
3375440936
Professional Enrollment ID
I20230715000551
Address ID
NE681051899OM4102XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,112 NURSE PRACTITIONER in NE

Provider Addresses for KERRY L TAKEDA (APRN)

  • 8074 S 84TH ST

    LA VISTA, NE 681283303

    Phone: (402) 779-7207

    Fax: (402) 779-7210

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 115 Open Payments records for all available years, with a total value of $2,254.

Total Amount is formed as General ($2,254) + Research ($0) + Ownership ($0) = $2,254.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: AIMMUNE THERAPEUTICS, INC. ($224).

Total Amount

$2,254

General + Research + Ownership

Payments

115

Total payment records

General Amount

$2,254

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230715000551INurse PractitionerNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68128)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375440936View full group profile
NameSpecialtyState
P S Y C H I A T R YNE
Family PracticeNE
Nurse PractitionerNE
Nurse PractitionerNE
P S Y C H I A T R YNE
-NE
Mental Health CounselorNE
P S Y C H I A T R YNE
P S Y C H I A T R YNE
Diagnostic RadiologyAZ

Reviews

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Frequently asked questions

Is KERRY L TAKEDA (APRN) listed with a National Provider Identifier?
Yes — KERRY L TAKEDA (APRN) has NPI 1811681497 on file in the registry.
Is there an active status for KERRY L TAKEDA (APRN)?
For scheduling context, KERRY L TAKEDA (APRN) is shown as active in the registry.
How would a patient describe KERRY L TAKEDA (APRN)'s focus?
For KERRY L TAKEDA (APRN), the primary taxonomy reads as Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is KERRY L TAKEDA (APRN) associated with La Vista?
Public fields place KERRY L TAKEDA (APRN) around La Vista, Nebraska. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for KERRY L TAKEDA (APRN) is noted as June 6, 2023 where the registry provides it.

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