NEBRASKA HEART INSTITUTE PC (NPI# 1336125202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336125202 |
| Entity Type | Organization |
| Organization Name | NEBRASKA HEART INSTITUTE PC |
| Practice Address |
7440 South 91st Street Lincoln NE 68526-9797 |
| Mailing Address |
Po Box 82585 Lincoln NE 68501-2585 |
| Practice Telephone | 4024896555 |
| Practice Fax Number | 4023283989 |
| Mailing Telephone | 4024896555 |
| Mailing Fax Number | 4023283989 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-08-11 |
| Authorized Official Name | MR. MARLIN AUSDEMORE (CONTROLLER) |
| Authorized Official Telephone | 4023283721 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0537043 | 05 | |
| KS | 20 862808 01 | 05 |
| Street Address |
7440 SOUTH 91ST STREET |
| City | LINCOLN |
| State | NE |
| Zip Code | 68526-9797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881251189 | Jennifer Demesquita Harrison | Nurse Practitioner | Alivation Health, 8550 Cuthills Circle, Lincoln, NE 68526 | 2019-05-22 |
| 1265954648 | Grant Essink | Dentist | 7822 South 96th Bay, Lincoln, NE 68526 | 2017-07-07 |
| 1528405719 | Charles Weston Whitten | Anesthesiology | 4546 S 86th St Ste B, Lincoln, NE 68526 | 2013-05-28 |
| 1912055112 | Hemantha Kumar Koduri | Internal Medicine | 4445 S 86th St Ste 100, Lincoln, NE 68526 | 2007-01-06 |
| 1306909585 | Melanie J Fulton | Dentist | 4525 So 86th, Ste A, Lincoln, NE 68526 | 2006-12-18 |
| 1952359812 | Kathleen Ann Packard | Pharmacist | 7440 S 91st Street, Lincoln, NE 68526 | 2006-05-04 |
| 1861932444 | Amber Walter | Advanced Practice Midwife | 9110 Andermatt Drive, Ste 2, Lincoln, NE 68526 | 2017-03-02 |
| 1801205794 | Danielle Melissa Kollasch | Physician Assistant | 8550 Cuthills Circle, Lincoln, NE 68526 | 2014-08-05 |
| 1891132700 | Michaela Irene Kadavy | Counselor | 4545 S 86th St, Lincoln, NE 68526 | 2013-05-31 |
| 1578827614 | Sams West Inc | Technician/Technologist | 8480 Andermatt Dr, Lincoln, NE 68526 | 2012-07-03 |
| Find all providers in zip 68526 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750903068 | Matrix Medical Network of Nebraska PC | Internal Medicine | 233 S 13th St Ste 1900, Lincoln, NE 68508-2000 | 2020-05-08 |
| 1013282821 | William Boaz Stason | Internal Medicine | 29 Sandy Pond Rd, Lincoln, MA 01773-2006 | 2012-03-12 |
| 1912055112 | Hemantha Kumar Koduri | Internal Medicine | 4445 S 86th St Ste 100, Lincoln, NE 68526 | 2007-01-06 |
| 1316025505 | Robert Lee Percell Jr. | Internal Medicine | 1600 S 48th St Ste 600, Lincoln, NE 68506-1275 | 2006-11-02 |
| 1922088657 | Kaliprasad N Ayala | Internal Medicine | 7440 S 91st St, Lincoln, NE 68526-9797 | 2006-01-19 |
| 1346731759 | Cardiovascular Clinic of Nebraska LLC | Internal Medicine | 6940 Van Dorn St Ste 201, Lincoln, NE 68506-2858 | 2018-05-21 |
| 1164666095 | Christopher R Balwanz | Internal Medicine | 1600 S 48th St, Ste 600, Lincoln, NE 68506-1275 | 2009-04-22 |
| 1487859658 | Charles Stephen Wilson | Internal Medicine | 1500 S 48th St, Lincoln, NE 68506-1225 | 2007-06-18 |
| 1598880098 | Ajay Chander | Internal Medicine | 7440 S 91st St, Lincoln, NE 68526-9797 | 2007-03-21 |
| 1346321981 | Walid Michael Kutayli | Internal Medicine | 1600 S 48th St, Suite 600, Lincoln, NE 68506-1283 | 2006-10-18 |
| Find all providers in LINCOLN | ||||
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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.