ALEGENT CREIGHTON CLINIC (NPI# 1548287907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548287907 |
| Entity Type | Organization |
| Organization Name | ALEGENT CREIGHTON CLINIC |
| Other Organization Name | CHI HEALTH CLINIC |
| Practice Address |
7500 Mercy Rd Omaha NE 68124-2319 |
| Mailing Address |
7261 Mercy Rd Attn: Credentialing Omaha NE 68124-2311 |
| Practice Telephone | 4027172500 |
| Mailing Telephone | 4023986255 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-09-02 |
| 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 |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | MEDICARE PTAN | 098675 | 01 |
| NE | MEDICARE PTAN | 098678 | 01 |
| NE | MEDICARE PTAN | 098672 | 01 |
| NE | MEDICARE PTAN | 098684 | 01 |
| NE | MEDICARE PTAN | 098686 | 01 |
| NE | MEDICARE PTAN | 098676 | 01 |
| NE | MEDICARE PTAN | 098680 | 01 |
| NE | MEDICARE PTAN | 098688 | 01 |
| NE | MEDICARE PTAN | 098691 | 01 |
| NE | MEDICARE PTAN | 098694 | 01 |
| NE | MEDICARE PTAN | 099398 | 01 |
| NE | MEDICARE PTAN | 098682 | 01 |
| NE | MEDICARE PTAN | 098685 | 01 |
| NE | MEDICARE PTAN | 098695 | 01 |
| NE | MEDICARE PTAN | 098673 | 01 |
| Other Name | Type Code |
|---|---|
| CHI Health Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12809 W Dodge Rd, Omaha, NE 681542155 | 4023434409 |
| 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 |
| 1518227859 | Alegent Creighton Clinic | Allergy & Immunology | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2012-05-21 |
| 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 |
| 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 |
7500 MERCY RD |
| City | OMAHA |
| State | NE |
| Zip Code | 68124-2319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295728368 | Thomas W Frederickson | Internal Medicine | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2005-08-24 |
| 1356940381 | Brenna M Hobson | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-10-21 |
| 1538778246 | Dua Noor Butt | Internal Medicine | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-07-28 |
| 1730706185 | Stephen James Cooper | Internal Medicine | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-07-01 |
| 1609493527 | Meghan E Farquhar | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-06-26 |
| 1275158909 | Rebecca M Toomsen | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-06-09 |
| 1770106783 | Jennifer E Cook | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-05-26 |
| 1427671445 | Wesley J Kerman | Student in an Organized Health Care Education/Training Program | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-05-26 |
| 1427670678 | Nicholas David Tran | Surgery | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-05-11 |
| 1538712260 | Kirsten A Boedeker-jenkins | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2019-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891312443 | Stefany Malanka | Family Medicine | 7710 Mercy Rd, Suite 202, Cu Department of Family Medicine, Omaha, NE 68124 | 2020-06-30 |
| 1902468937 | Keith William Vrbicky Jr. | Obstetrics & Gynecology | 7710 Mercy Road, Suite 202 - Cu Department of Ob/gyn, Omaha, NE 68124 | 2019-06-29 |
| 1699255869 | Nicholas Williams | Psychiatry & Neurology | 7701 Mercy Road, Suite 601, Omaha, NE 68124 | 2018-08-17 |
| 1801315197 | Sweet Dreams Anesthesia | Clinic/Center | 1755 Ridgewood Ave, Omaha, NE 68124 | 2017-09-18 |
| 1295257657 | Margaret R Hodges | Dietitian, Registered | 8715 Oak Street, Omaha, NE 68124 | 2017-07-07 |
| 1346761061 | Meredith Shama | Obstetrics & Gynecology | 7710 Mercy Rd Ste 202-cu Department of Obgyn, Omaha, NE 68124 | 2017-07-03 |
| 1578010542 | Mary Ellen Royer | Counselor | 8715 Oak St., Omaha, NE 68124 | 2016-09-07 |
| 1750759361 | Pain Centers of The Midlands LLC | Anesthesiology | 2808 S. 80th Ave, Suite 230, Omaha, NE 68124 | 2015-09-14 |
| 1184005738 | Sharon D Jackson | Counselor | 8031 West Center Rd Ste 207, Omaha, NE 68124 | 2015-06-09 |
| 1841631215 | Nebraska Organ Recovery System | Organ Procurement Organization | 8502 West Center Road, Omaha, NE 68124 | 2013-07-12 |
| Find all providers in zip 68124 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968408 | Joanna Sarah Jacob | Family Medicine | 3601 Jones St Apt 350, Omaha, NE 68105-1526 | 2020-07-05 |
| 1255958443 | Sreelakshmi Surendran Pillai | Family Medicine | 7710 Mercy Road, Suite 202-cu, Department of Family Mediicine, Omaha, NE 68124-2353 | 2020-07-03 |
| 1891312443 | Stefany Malanka | Family Medicine | 7710 Mercy Rd, Suite 202, Cu Department of Family Medicine, Omaha, NE 68124 | 2020-06-30 |
| 1831714062 | Allison Alise Bird | Family Medicine | Family Practice 983075 Nebraska Medical Center, Omaha, NE 68198-3075 | 2020-06-12 |
| 1285267526 | Banyan Medical Systems | Family Medicine | 8656 F St, Plaza F, Omaha, NE 68127-1639 | 2020-02-14 |
| 1659938777 | Hannah Luksa | Family Medicine | 983075 Nebraska Medical Center Omaha Ne 68198-3075, Omaha, NE 68198-3075 | 2019-05-23 |
| 1881259646 | Grant Saltzgaber | Family Medicine | Unmc Dept. of Family Medicine, 983075 Nebraska Medical Center, Omaha, NE 68198 | 2019-05-07 |
| 1710458237 | Quality Living Inc | Family Medicine | 6320 N 70th Plz, Omaha, NE 68104-1072 | 2018-12-10 |
| 1851871735 | Cornerstone Nonprofit Healthcare | Family Medicine | 1313 N 48th Ave, Omaha, NE 68132-1612 | 2018-08-20 |
| 1306368691 | Mitchell Kohl | Family Medicine | 16104 Sprague St, Omaha, NE 68116-2895 | 2017-07-09 |
| 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.