DR. RANDALL DUCKERT (NPI# 1376508960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376508960 |
| Entity Type | Individual |
| Full Name | DR. RANDALL DUCKERT |
| Credential | M.D. |
| Practice Address |
8303 Dodge St Suite Ll6 Omaha NE 68114-4108 |
| Mailing Address |
Po Box 10190 Virginia Beach VA 23450-0190 |
| Practice Telephone | 4023544104 |
| Practice Fax Number | 4023548761 |
| Mailing Telephone | 8004775240 |
| Mailing Fax Number | 7574636572 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2014-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
20144 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 100257759 | 05 | |
| NE | RAILROAD MEDICARE | P00060114 | 01 |
| IA | 1376508960 | 05 | |
| NE | 470376604-02 | 05 |
| Street Address |
8303 DODGE ST SUITE LL6 |
| City | OMAHA |
| State | NE |
| Zip Code | 68114-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629061528 | Herbert Arthur Hartman Jr. | Internal Medicine | 8303 Dodge St, Ste 225, Omaha, NE 68114 | 2005-08-25 |
| 1487251120 | The Nebraska Methodist Hospital | Clinical Medical Laboratory | 8303 Dodge St, Omaha, NE 68114-4108 | 2020-10-06 |
| 1538771381 | Krista Villarreal | Nurse Practitioner | 8303 Dodge St, Omaha, NE 68114-4108 | 2020-08-21 |
| 1437769163 | Julie Juddi | Dietitian, Registered | 8303 Dodge St, Omaha, NE 68114-4108 | 2020-08-06 |
| 1023631934 | Jaclyn E Kenney | Nurse Practitioner | 8303 Dodge St, Omaha, NE 68114-4108 | 2020-05-26 |
| 1215558846 | Linda Yen Nong | Pharmacist | 8303 Dodge St, Omaha, NE 68114-4108 | 2020-05-05 |
| 1265990303 | Amanda J Nelson | Registered Nurse | 8303 Dodge St, Omaha, NE 68114-4108 | 2019-03-07 |
| 1194283226 | Haley R Mcmillin | Registered Nurse | 8303 Dodge St, Omaha, NE 68114-4108 | 2019-03-07 |
| 1336618578 | Emily Schlautman | Physician Assistant | 8303 Dodge St, Suite 225, Omaha, NE 68114-4108 | 2018-11-16 |
| 1134602105 | Michael Gurtler | Genetic Counselor, MS | 8303 Dodge St, Omaha, NE 68114-4108 | 2018-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1023568540 | Active Spine Physical Therapy, LLC | Clinic/Center | 10110 Nicholas St Ste 100, Omaha, NE 68114 | 2016-10-07 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1912268897 | Amir Zahra | Radiology | 6901 N 72nd St Ste 2244, Omaha, NE 68122-1709 | 2012-06-06 |
| 1043622764 | Michael Baine | Radiology | 505 S. 45th St, Omaha, NE 68198-1045 | 2014-05-29 |
| 1336402874 | Nathan Ronald Bennion | Radiology | 515 S 48th St, Omaha, NE 68198-4334 | 2012-06-20 |
| 1083901698 | Nicole Wanda Catherine Nolan | Radiology | 8303 Dodge St, Suite Ll6, Omaha, NE 68114-4108 | 2011-07-03 |
| 1902124936 | Chi Zhang | Radiology | Emile 42nd St, Omaha, NE 68198-1045 | 2010-05-14 |
| 1124206602 | Andrew O Wahl | Radiology | 988102 Nebraska Medical Ctr, Omaha, NE 68198-8102 | 2008-02-06 |
| 1912192907 | Alegent Health Immanuel Medical Center | Radiology | 6901 N 72nd St, Omaha, NE 68122-1709 | 2007-09-12 |
| 1801930441 | Alireza Mirmiran | Radiology | 8303 Dodge St, Suite # Ll6, Omaha, NE 68114-4108 | 2007-02-16 |
| 1821190752 | Cam Nguyen | Radiology | 601 N 30th St, Omaha, NE 68131-2137 | 2006-09-01 |
| Find all providers in OMAHA | ||||
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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.