ALEGENT CREIGHTON CLINIC (NPI# 1518227859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518227859 |
| Entity Type | Organization |
| Organization Name | ALEGENT CREIGHTON CLINIC |
| Other Organization Name | CHI HEALTH CLINIC |
| Practice Address |
12809 W Dodge Road Omaha NE 68154-2155 |
| Mailing Address |
7261 Mercy Rd Attn: Credentialing Omaha NE 68124-2311 |
| Practice Telephone | 4023986255 |
| Practice Fax Number | 4028298513 |
| Mailing Telephone | 4023986255 |
| Mailing Fax Number | 4028298513 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2016-12-21 |
| Authorized Official Name | KEITH JANKUSKI (COO) |
| Authorized Official Telephone | 4023434409 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHI NEBRASKA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CHI Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285082917 | Alegent Creighton Clinic | Podiatrist | 1413 S Washington St, Ste 200, Papillion, NE 68046-4165 | 2016-06-03 |
| 1588012397 | Alegent Creighton Clinic | Podiatrist | 16909 Lakeside Hills Ct, Suite 208, Omaha, NE 68130-4664 | 2016-06-02 |
| 1699035931 | Alegent Creighton Clinic | Family Medicine | 12809 W Dodge Rd, Omaha, NE 68154-2155 | 2012-05-21 |
| 1912267238 | Alegent Creighton Clinic | Clinical Medical Laboratory | 12809 W Dodge Rd, Omaha, NE 68154-2155 | 2012-05-21 |
| 1154680700 | Alegent Creighton Clinic | Allergy & Immunology | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2012-05-16 |
| 1225332430 | Alegent Creighton Clinic | Clinic/Center | 1203 S Locust St, Glenwood, IA 51534-1872 | 2011-01-03 |
| 1598811069 | Alegent Creighton Clinic | Internal Medicine | 800 Mercy Dr, Council Bluffs, IA 51503-3128 | 2007-01-26 |
| 1134283013 | Alegent Creighton Clinic | Obstetrics & Gynecology | 800 Mercy Dr, Suite 210, Council Bluffs, IA 51503-3128 | 2006-12-21 |
| 1548287907 | Alegent Creighton Clinic | Family Medicine | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2006-07-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALEGENT CREIGHTON CLINIC | 12809 W Dodge Rd, Omaha, NE 68154-2155 |
| Iowa Business Entities | ALEGENT CREIGHTON CLINIC | 12809 West Dodge Road, Omaha, NE 68154 |
| Street Address |
12809 W DODGE ROAD |
| City | OMAHA |
| State | NE |
| Zip Code | 68154-2155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033288923 | Alegent Creighton Health | Dietitian, Registered | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2006-11-07 |
| 1154680700 | Alegent Creighton Clinic | Allergy & Immunology | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275149262 | Vervech | Counselor | 11422 Miracle Hills Drive, Suite 401, Omaha, NE 68154 | 2020-09-16 |
| 1891318150 | Pure Massage, LLC | Massage Therapist | Pure Massage, LLC, 11316 Davenport St, Omaha, NE 68154 | 2020-05-21 |
| 1326682592 | Andrea Dawn Degner | Counselor | 11580 W. Dodge Frontage Rd, Omaha, NE 68154 | 2019-10-31 |
| 1669035150 | Gerard Thomas IIi | Physical Therapist | Triage LLC, 12020 Pacific Street, Omaha, NE 68154 | 2019-04-19 |
| 1306311352 | Sakrx, LLC | Pharmacy | 624 N 114th St, Omaha, NE 68154 | 2018-10-05 |
| 1033622782 | Raquelle G. Rowe | Registered Nurse | 11840 Nicholas Street Suite 215, Med Staff, Omaha, NE 68154 | 2017-11-15 |
| 1336680396 | Kristi Bose | Nurse Practitioner | 11422 Miracle Hills Dr Ste 401, Omaha, NE 68154 | 2017-03-10 |
| 1326442781 | Heather Andsager | Pharmacy Technician | 13360 California Street, Omaha, NE 68154 | 2014-10-14 |
| 1073917605 | Ann Leever | Pharmacist | 505 N 155th Plaza, Omaha, NE 68154 | 2014-10-10 |
| 1689078222 | Melissa Svec | Emergency Medical Technician, Basic | 1705 N 121st St #203, Omaha, NE 68154 | 2014-10-10 |
| Find all providers in zip 68154 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1578171468 | Meghana Vijay Khedekar | Internal Medicine | 7710 Mercy Road Cu Department of Internal Medicine, Suite 202, Omaha, NE 68124-2353 | 2020-07-17 |
| 1104441443 | Justin Lawrence Burr | Internal Medicine | 982055 Nebraska Medical Center Omaha Ne 68198-2055, Omaha, NE 68198-5524 | 2020-06-12 |
| 1952963241 | Bryton Evan Perman | Internal Medicine | Suite 202, Cu Department of Internal Medicine, 7710 Mercy Road, Omaha, NE 68124-2353 | 2019-07-08 |
| 1487211793 | Gulsen Ozen | Internal Medicine | 983332 Nebraska Medical Ctr Dept Of, Omaha, NE 68198-3332 | 2019-05-22 |
| 1619457868 | Jalal Mohamed Dufani | Internal Medicine | Creighton University Internal Medicine, 7710 Mercy Road, Suite 202, Omaha, NE 68124-6812 | 2018-08-17 |
| 1437638640 | Krishnachaitanya Reddy Pallamala | Internal Medicine | 7710 Mercy Road, Suite 202 - Cu Inernal Medicine, Omaha, NE 68124-2353 | 2018-08-08 |
| 1750877510 | Collaborative Care Associates PC | Internal Medicine | 3410 N 140th St, Omaha, NE 68164-5400 | 2018-07-05 |
| 1477048593 | Sai Giridhar Gundepalli | Internal Medicine | 7710 Mercy Road, Cu Department of Internal Medicine, Suite 202, Omaha, NE 68124-2353 | 2018-07-01 |
| 1831684463 | Tyler Gallo | Internal Medicine | 982005 Nebraska Medical Center, Omaha, NE 68198-2055 | 2018-06-26 |
| 1992221808 | Ahmad Al-tamimi | Internal Medicine | 7710 Mercy Rd Ste 202-cu, Omaha, NE 68124-2372 | 2017-08-22 |
| 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.