ALEGENT CREIGHTON HEALTH (NPI# 1417975483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417975483 |
| Entity Type | Organization |
| Organization Name | ALEGENT CREIGHTON HEALTH |
| Other Organization Name | ALEGENT HEALTH LAKESIDE IDTF |
| Practice Address |
17030 Lakeside Hills Plz Omaha NE 68130-2396 |
| Mailing Address |
Po Box 642117 Omaha NE 68164-8117 |
| Practice Telephone | 4027585060 |
| Practice Fax Number | 4027585079 |
| Mailing Telephone | 4027174377 |
| Mailing Fax Number | 4027174317 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-08-21 |
| Authorized Official Name | CLIFF A ROBERTSON (CEO CHI HEALTH) |
| Authorized Official Telephone | 4023434343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Alegent Health Lakeside IDTF | Doing Business As Name - Organization |
| CHI Health Lakeside Imaging | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295293744 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 1288 Valley View Drive, Pharmacy Ste 101, Council Bluffs, IA 51503-5245 | 2019-03-04 |
| 1104251628 | Alegent Creighton Health | Radiology | 17201 Wright St Ste 100, Omaha, NE 68130-2042 | 2013-09-04 |
| 1952660615 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 8248 S 96th St Ste 101, La Vista, NE 68128-3126 | 2012-05-15 |
| 1427317205 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 13315 W Center Rd Ste 101, Omaha, NE 68144-3449 | 2012-05-14 |
| 1164553954 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 17201 Wright St, Suite 202, Omaha, NE 68130-2042 | 2007-03-07 |
| 1033288923 | Alegent Creighton Health | Dietitian, Registered | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2006-11-07 |
| 1083700959 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 3308 Samson Way Ste 106a, Bellevue, NE 68123-3235 | 2006-10-05 |
| 1760578652 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 16909 Lakeside Hills Ct Ste 107, Omaha, NE 68130-4661 | 2006-10-05 |
| 1508213810 | Alegent Creighton Health | Clinic/Center | 11111 S 84th St, Papillion, NE 68046-4122 | 2016-05-17 |
| 1376910448 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 4220 L St, Omaha, NE 68107-1048 | 2015-08-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALEGENT CREIGHTON HEALTH | 7261 Mercy Rd, Omaha, NE 68124-2311 |
| Washington State Corporations | ALEGENT CREIGHTON HEALTH | 12809 W Dodge Rd, Omaha, NE 68154 |
| Street Address |
17030 LAKESIDE HILLS PLZ |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-2396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205834173 | Mendy Marie Peterson | Physician Assistant | 17030 Lakeside Hills Plz, Suite 102, Omaha, NE 68130-2396 | 2005-07-13 |
| 1710426549 | Jessica Cannon | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2017-02-13 |
| 1881132256 | Kakish Md Senior Care, PC | Hospitalist | 17030 Lakeside Hills Plz, Suite 130, Omaha, NE 68130-2396 | 2017-02-06 |
| 1205373776 | Hayley Christensen | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130 | 2017-01-23 |
| 1114460904 | Ellen A Thomsen | Dietitian, Registered | 17030 Lakeside Hills Plz, Omaha, NE 68130-2396 | 2016-11-28 |
| 1811238728 | Sarah P Hennings | Physician Assistant | 17030 Lakeside Hills Plz, Ste 202, Omaha, NE 68130-2396 | 2013-03-04 |
| 1245472786 | Jaime L Dobson | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2009-03-30 |
| 1699917492 | Nicholas Wegner | Orthopaedic Surgery | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2009-03-25 |
| 1619116183 | Infectious Disease & Epidemiology Associates PC | Internal Medicine | 17030 Lakeside Hills Plz, Suite 202, Omaha, NE 68130-2396 | 2009-02-06 |
| 1386889442 | Gross, Iwersen, Kratochvil & Klein Md PC | Orthopaedic Surgery | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2008-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251628 | Alegent Creighton Health | Radiology | 17201 Wright St Ste 100, Omaha, NE 68130-2042 | 2013-09-04 |
| 1205090966 | Elon Joshua Granader | Radiology | Emile @ 42nd St, Omaha, NE 68198-1045 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225121916 | Advanced Open Mri, LLC | Radiology | 7601 Pioneers Boulevard, Lincoln, NE 68506 | 2006-10-02 |
| 1265631287 | Christopher W. Colling | Radiology | 7601 Pioneers Blvd, Lincoln, NE 68506-4675 | 2007-07-11 |
| 1437116936 | Advanced Medical Imaging, LLC | Radiology | 7601 Pioneers Blvd, Lincoln, NE 68506-4675 | 2006-04-27 |
| 1508829292 | Curtis R Burhoop | Radiology | 7601 Pioneers Blvd, Lincoln, NE 68506-4675 | 2006-04-11 |
Please comment or provide details below to improve the information on ALEGENT CREIGHTON HEALTH.
| 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.