ALEGENT CREIGHTON CLINIC


Address: 12809 W Dodge Rd, Omaha, NE 68154-2155
Phone: 4023434328

ALEGENT CREIGHTON CLINIC (NPI# 1699035931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699035931
Entity Type Organization
Organization Name ALEGENT CREIGHTON CLINIC
Other Organization Name ALEGENT HEALTH CLINIC - CREIGHTON MEDICAL ASSOCIATES - RR
Practice Address 12809 W Dodge Rd
Omaha
NE 68154-2155
Practice Telephone 4023434328
Practice Fax Number 4023434389
Mailing Telephone 4023434328
Mailing Fax Number 4023434389
Enumeration Date 2012-05-21
Last Update Date 2012-07-24
Authorized Official Name MAUREEN A CAVANAUGH (COMPLIANCE OFFICER)
Authorized Official Telephone 4023434328
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Alegent Health Clinic - Creighton Medical Associates - RR Doing Business As Name - Organization

Other Provider IDs and Locations

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
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

Other Data Sources

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

Office Location

Street Address 12809 W DODGE RD
City OMAHA
State NE
Zip Code 68154-2155

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982773776 Alegent Health Bergan Mercy Health System Dietitian, Registered 12809 W Dodge Rd, Omaha, NE 68154-2155 2006-11-07
1912267238 Alegent Creighton Clinic Clinical Medical Laboratory 12809 W Dodge Rd, Omaha, NE 68154-2155 2012-05-21
1770854663 Alegent Health Bergan Mercy Health System Internal Medicine 12809 W Dodge Rd, Omaha, NE 68154-2155 2012-01-24
1457590846 Rebecca Lyn Wardlaw Specialist/Technologist 12809 W Dodge Rd, Omaha, NE 68154-2155 2009-02-09

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City OMAHA
Zip Code 68154

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Dataset Information

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.

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