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Deactivated NPI 1225527088 Deactivated / Inactive NPI Female Practitioner

Roni Rene' Wilder , PEER SUPPORT

Peer Specialist • Omaha, NE

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Roni Wilder has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 08, 2018
NPI Deactivation Date August 19, 2019
Total Practice Duration ~1 Years of Practice (2018 – 2019)

Professional Overview & Biography Verified Profile Summary

Roni Wilder, PEER SUPPORT was a registered Peer Specialist practicing in Omaha, NE. Throughout an active medical career spanning 1 years, Roni Wilder provided care at the practice location at 1709 JACKSON ST until profile deactivation on 2019-08-19.

Practice Location & Contact Primary Location

Practice Address

1709 Jackson St

Omaha, NE 681022513

Telephone 4025992686

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Omaha, NE

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
52 Specialists

Practicing in Omaha, NE (178 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Robert Brock , MS, LMHP, PLADC, LPC

Counselor - Mental Health

NPI 1023414331

Master of Science, LMHP, PLADC, Licensed Professional Counselor

Justine Wall , MS

Counselor - Mental Health

NPI 1376664284

Master of Science

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 19, 2019

Record deactivated on August 19, 2019

NPI Profile Active May 08, 2018

NPI status registered as active in NPPES database

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Updated Practice Location May 08, 2018

Registered at 1709 JACKSON ST, OMAHA, NE 681022513 (Tel: 4025992686)

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Updated Business Mailing Address May 08, 2018

Registered at 1709 JACKSON ST, OMAHA, NE 681022513 (Tel: 4025992686)

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Provider Name / Credentials Updated May 08, 2018

Recorded as RONI WILDER, PEER SUPPORT

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2018

Peer Specialist

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Initial NPI Registration & Enumeration May 08, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225527088
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 08, 2018
Last Update: May 08, 2018
Deactivation Date: August 19, 2019

Mailing Address

1709 Jackson St

Omaha, NE 681022513

Phone: 4025992686

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.