PONCA TRIBE OF NEBRASKA (NPI# 1194244939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194244939 |
| Entity Type | Organization |
| Organization Name | PONCA TRIBE OF NEBRASKA |
| Other Organization Name | FRED LEROY HEALTH AND WELLNESS CENTER DENTAL CLINIC |
| Practice Address |
2602 J St Omaha NE 68107-1643 |
| Practice Telephone | (402) 733-3612 |
| Mailing Telephone | 4027333612 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MR. LARRY VOEGELE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4024389222 |
| Is Organization Subpart | Y |
| Parent Organization Name | PONCA TRIBE OF NEBRASKA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fred LeRoy Health and Wellness Center Dental Clinic | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Syracuse Ave, Norfolk, NE 687012458 | 4023718780 | 4023794293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598930117 | Ponca Tribe of Nebraska | Community/Behavioral Health | 1701 E St, Lincoln, NE 68508-3429 | 2008-04-24 |
| 1447434261 | Ponca Tribe of Nebraska | Community/Behavioral Health | 1800 Syracuse Ave, Norfolk, NE 68701-2458 | 2007-12-28 |
| 1740681832 | Ponca Tribe of Nebraska | Clinic/Center | 2602 J St, Omaha, NE 68107-1643 | 2014-09-09 |
| 1013260561 | Ponca Tribe of Nebraska | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1800 Syracuse Ave, Norfolk, NE 68701-2458 | 2012-10-22 |
| 1285987735 | Ponca Tribe of Nebraska | Clinic/Center | 1800 Syracuse Ave, Norfolk, NE 68701-2458 | 2012-10-22 |
| 1760778385 | Ponca Tribe of Nebraska | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2602 J St, Fred Leroy Health and Wellness Center Pharmacy, Omaha, NE 68107-1643 | 2011-06-22 |
| 1295058733 | Ponca Tribe of Nebraska | Community/Behavioral Health | 2602 J St, Omaha, NE 68107-1643 | 2010-03-11 |
| 1356673040 | Ponca Tribe of Nebraska | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2602 J St, Omaha, NE 68107-1643 | 2010-02-04 |
| 1710172879 | Ponca Tribe of Nebraska | Case Management | 2602 J St, Omaha, NE 68107-1643 | 2007-09-12 |
| Street Address |
2602 J ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68107-1643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700871381 | Mary Margaret Murphy | Nurse Practitioner | 2602 J St, Omaha, NE 68107-1643 | 2005-09-20 |
| 1033739537 | Rachael M Bogacz | Counselor | 2602 J St, Omaha, NE 68107-1643 | 2020-04-24 |
| 1821632266 | Alison Jordan | Dietitian, Registered | 2602 J St, Omaha, NE 68107-1643 | 2019-10-29 |
| 1669964003 | Tayler Danyelle Fuller | Dentist | 2602 J St, Omaha, NE 68107-1643 | 2018-06-01 |
| 1205335502 | Lorri Lynne Mckean | Dental Hygienist | 2602 J St, Omaha, NE 68107-1643 | 2018-02-02 |
| 1326567660 | Maria Douthett | Nurse Practitioner | 2602 J St, Omaha, NE 68107-1643 | 2017-09-19 |
| 1851772776 | Tracy Lautt | Dental Hygienist | 2602 J St, Omaha, NE 68107-1643 | 2015-06-16 |
| 1326441098 | Whitney Anne Arnold | Registered Nurse | 2602 J St, Omaha, NE 68107-1643 | 2014-10-08 |
| 1679974455 | Nicole Leigh Rezac | Dietitian, Registered | 2602 J St, Omaha, NE 68107-1643 | 2014-09-11 |
| 1740681832 | Ponca Tribe of Nebraska | Clinic/Center | 2602 J St, Omaha, NE 68107-1643 | 2014-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326404773 | Halee Austin Emerson | Speech-Language Pathologist | 5101 S 17th Street, Omaha, NE 68107 | 2016-01-14 |
| 1942513494 | Oneworld Community Health Centers, Inc. | Clinic/Center | 4215 S 20th St, Omaha, NE 68107 | 2010-07-26 |
| 1871740753 | Dawson E Dvorak | Counselor | 5217 S. 28th Street, Stephen Center Hero Program, Omaha, NE 68107 | 2008-08-22 |
| 1750547485 | Concentra Health Services, Inc. | Clinic/Center | 2900 F Street, Omaha, NE 68107 | 2008-08-01 |
| 1164550836 | Joyce A Sargent | Pharmacist | 3548 Q Street, Omaha, NE 68107 | 2007-03-02 |
| 1326192758 | Elizabeth H Buschkemper | Nurse Practitioner | 4920 S. 30th St. Suite 103, Oneworld Community Health Center, Omaha, NE 68107 | 2007-01-23 |
| 1578647772 | Heartland Emergicare | Emergency Medicine | Heartland Emergicare, 2429 M Str, Omaha, NE 68107 | 2006-10-24 |
| 1225125057 | Physicians Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 3353 L Street, Omaha, NE 68107 | 2006-10-05 |
| 1033135595 | Heartland Emergicare, P.C. | Physician Assistant | 2429 M Street, Omaha, NE 68107 | 2006-07-15 |
| 1487695870 | Patricia Rose Farrell | Social Worker | 5511 S 31st St, Omaha, NE 68107 | 2006-06-09 |
| Find all providers in zip 68107 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457984817 | Dudzinski Dental PC | Clinic/Center | 3423 S 72nd St, Omaha, NE 68124-3573 | 2020-02-13 |
| 1295251023 | Matthew L. Freyer, D.d.s., P.C. | Clinic/Center | 8424 W Center Rd Ste 100, Omaha, NE 68124-3138 | 2017-08-14 |
| 1699296368 | Thomas M. Sanders Dds, LLC | Clinic/Center | 9961 S. 168th St., Omaha, NE 68136 | 2017-07-03 |
| 1477818862 | 7 Day Dental of Omaha, LLC | Clinic/Center | 7337 Farnam St, Omaha, NE 68114-4627 | 2012-07-11 |
| 1831326826 | Omalee Dental LLC | Clinic/Center | 14 Sixth Ave, Omaha, GA 31821 | 2009-06-17 |
| 1043818438 | Miboca 1 LLC | Clinic/Center | 5305 S 96th St, Omaha, NE 68127-3317 | 2020-10-16 |
| 1629690318 | Smith & Hascall Family Dentistry LLC | Clinic/Center | 17725 Welch Plz Ste B, Omaha, NE 68135-1404 | 2020-05-15 |
| 1669036042 | Nia Jones Orthodontics PC | Clinic/Center | 14707 California St Ste 8, Omaha, NE 68154-1900 | 2019-05-01 |
| 1326535261 | Dylan C Gaillard, Dds, LLC | Clinic/Center | 12828 Augusta Ave, Omaha, NE 68144-3733 | 2018-04-17 |
| 1700373602 | Dylan C Gaillard, Dds, LLC | Clinic/Center | 2526 S 140th St, Omaha, NE 68144-2339 | 2018-04-16 |
| Find all providers in OMAHA | ||||
Please comment or provide details below to improve the information on PONCA TRIBE OF NEBRASKA.
| 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.