TANNER JORDAN WALLEN (NPI# 1043731870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043731870 |
| Entity Type | Individual |
| Full Name | TANNER JORDAN WALLEN |
| Credential | DO |
| Practice Address |
7710 Mercy Rd Ste 202 Omaha NE 68124-2353 |
| Practice Telephone | (402) 280-4392 |
| Mailing Telephone | 4022804392 |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2017-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 7943 | NE | Student, Health Care |
| Street Address |
7710 MERCY RD STE 202 |
| City | OMAHA |
| State | NE |
| Zip Code | 68124-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629326509 | Shantanu Patil | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2012-08-26 |
| 1477165744 | Diana Veronica Steau | Family Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-08-18 |
| 1265043327 | Vinay Bhushan Reddy Lakki | Psychiatry & Neurology | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-08-12 |
| 1265041818 | Vaishnavi Kuta Ganesan | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-29 |
| 1376151027 | Dana Skonseng | Obstetrics & Gynecology | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-20 |
| 1205444981 | Philip Thomas Ryan | Psychiatry & Neurology | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-17 |
| 1831707017 | Mahmoud Ismayl | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-14 |
| 1588282875 | Abubakar Tauseef | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-13 |
| 1891313177 | Anna L Cheek | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-13 |
| 1932727187 | Elizabeth Pruss | Internal Medicine | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | 2020-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891312443 | Stefany Malanka | Family Medicine | 7710 Mercy Rd, Suite 202, Cu Department of Family Medicine, Omaha, NE 68124 | 2020-06-30 |
| 1902468937 | Keith William Vrbicky Jr. | Obstetrics & Gynecology | 7710 Mercy Road, Suite 202 - Cu Department of Ob/gyn, Omaha, NE 68124 | 2019-06-29 |
| 1699255869 | Nicholas Williams | Psychiatry & Neurology | 7701 Mercy Road, Suite 601, Omaha, NE 68124 | 2018-08-17 |
| 1801315197 | Sweet Dreams Anesthesia | Clinic/Center | 1755 Ridgewood Ave, Omaha, NE 68124 | 2017-09-18 |
| 1295257657 | Margaret R Hodges | Dietitian, Registered | 8715 Oak Street, Omaha, NE 68124 | 2017-07-07 |
| 1346761061 | Meredith Shama | Obstetrics & Gynecology | 7710 Mercy Rd Ste 202-cu Department of Obgyn, Omaha, NE 68124 | 2017-07-03 |
| 1578010542 | Mary Ellen Royer | Counselor | 8715 Oak St., Omaha, NE 68124 | 2016-09-07 |
| 1750759361 | Pain Centers of The Midlands LLC | Anesthesiology | 2808 S. 80th Ave, Suite 230, Omaha, NE 68124 | 2015-09-14 |
| 1184005738 | Sharon D Jackson | Counselor | 8031 West Center Rd Ste 207, Omaha, NE 68124 | 2015-06-09 |
| 1841631215 | Nebraska Organ Recovery System | Organ Procurement Organization | 8502 West Center Road, Omaha, NE 68124 | 2013-07-12 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851902647 | Katia Lira Garcia | Student in an Organized Health Care Education/Training Program | 9153 Black St, Omaha, NE 68122-1823 | 2020-08-13 |
| 1508477589 | Nicole Amato | Student in an Organized Health Care Education/Training Program | 3306 S 52nd St, Omaha, NE 68106-3806 | 2020-08-12 |
| 1790393692 | Akshay Machanahalli Balakrishna | Student in an Organized Health Care Education/Training Program | 7710 Mercy Road, Suite 202 - Cu Department of Internal, Omaha, NE 68124-2353 | 2020-07-16 |
| 1124644703 | Michaelyn Aleah Everhart | Student in an Organized Health Care Education/Training Program | 9885575 Nebraska Medical Center, Omaha, NE 68198-5575 | 2020-06-19 |
| 1043836992 | Glen Sheridan Clinton | Student in an Organized Health Care Education/Training Program | 981150 Nebraska Medical Center Omaha Ne 68198-1150, Omaha, NE 68198-0001 | 2020-06-16 |
| 1548885809 | Adam P Zobel | Student in an Organized Health Care Education/Training Program | 984150 Nebraska Medical Ctr # 5597372, Omaha, NE 68198-4150 | 2020-06-12 |
| 1972127918 | Krysta Mary Sutyak | Student in an Organized Health Care Education/Training Program | 986880 Nebraska Medical Center, Omaha, NE 68198-3280 | 2020-06-05 |
| 1023630209 | Tuan Anh Quang Ta | Student in an Organized Health Care Education/Training Program | 4400 Emile St Rm 3601, Omaha, NE 68198-0600 | 2020-05-11 |
| 1902434186 | Andrew William Enzler | Student in an Organized Health Care Education/Training Program | 623 S 56th St, Omaha, NE 68106-1318 | 2020-04-01 |
| 1952937732 | Ran Jing | Student in an Organized Health Care Education/Training Program | Unmc College of Medicine 985520 Nebraska Medical Center, Omaha, NE 68198-5520 | 2020-03-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.