CHARLES DREW HEALTH CENTER, INC (NPI# 1720335284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720335284 |
| Entity Type | Organization |
| Organization Name | CHARLES DREW HEALTH CENTER, INC |
| Other Organization Name | CHARLES DREW HEALTH CENTER, INC AT JACKSON TOWER |
| Practice Address |
600 South 27th Street Omaha NE 68105-1502 |
| Mailing Address |
Po Box 30019 2915 Grant Street Omaha NE 68111-3863 |
| Practice Telephone | 4024571243 |
| Practice Fax Number | 4024531970 |
| Mailing Telephone | 4024513553 |
| Mailing Fax Number | 4024571220 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | MS. TARSHA DENISE JACKSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4024571215 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHARLES DREW HEALTH CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
NE | Ambulatory Health Care Facilities | |
| N | 363LC1500X |
Nurse Practitioner Specialization: Community Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LC1500X |
Nurse Practitioner Specialization: Community Health |
NE | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
NE | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 100262761-00 | 05 | |
| NE | NON-FQHC | 100262762-00 | 01 |
| Other Name | Type Code |
|---|---|
| Charles Drew Health Center, Inc at Jackson Tower | Doing Business As Name - Organization |
| Charles Drew Health Center, Inc at Jackson Tower | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952659930 | Charles Drew Health Center, Inc | Nurse Practitioner | 5100 Florence Blvd, Omaha, NE 68110-5346 | 2012-08-22 |
| 1346597895 | Charles Drew Health Center, Inc | Nurse Practitioner | 5904 Henniger Avenue, Omaha, NE 68183-0001 | 2012-08-14 |
| 1023365582 | Charles Drew Health Center, Inc | Nurse Practitioner | 3600 North 24th Street, Omaha, NE 68110-1872 | 2012-08-14 |
| 1811260219 | Charles Drew Health Center, Inc | Counselor | 8204 Crown Point Avenue, Omaha, NE 68134-1922 | 2012-02-15 |
| 1003100991 | Charles Drew Health Center, Inc | Clinic/Center | 1111 North 17th Street, Omaha, NE 68102-4119 | 2011-06-08 |
| 1639486343 | Charles Drew Health Center, Inc | Psychologist | 3720 Florence Blvd, Omaha, NE 68110-1737 | 2010-09-02 |
| 1629385331 | Charles Drew Health Center, Inc | Counselor | 3775 Curtis Avenue, Omaha, NE 68111-1169 | 2010-09-02 |
| 1285941997 | Charles Drew Health Center, Inc | Counselor | 1311 North 24th Street, Omaha, NE 68102-4010 | 2010-09-02 |
| 1255302170 | Charles Drew Health Center, Inc | Clinic/Center | 2915 Grant Street, Omaha, NE 68111-3863 | 2006-01-30 |
| Street Address |
600 SOUTH 27TH STREET |
| City | OMAHA |
| State | NE |
| Zip Code | 68105-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679018030 | Buoyant Family Services Counseling and Consulting LLC | Community/Behavioral Health | The Center 1941 South 42nd Street, Suite 416 S, Omaha, NE 68105 | 2016-12-21 |
| 1497104442 | Michael Lee Powell | Family Medicine | 4305 Dewey Ave, Omaha, NE 68105 | 2016-06-10 |
| 1164896361 | Kyla Haner | Counselor | 1941 S. 42nd St. Ste 514, Omaha, NE 68105 | 2015-11-25 |
| 1114359189 | Kayli Ann Bendlin | Pharmacist | 4101 Woolworth Ave.-mailstop 119, Va Medical Center-pharmacy Department, Omaha, NE 68105 | 2013-08-01 |
| 1740622372 | Ashley M Ortiz | Nurse Practitioner | 4350 Dewey Avenue, Omaha, NE 68105 | 2013-07-24 |
| 1043519655 | Mandy J Hansen | Counselor | 2101 S. 42nd Street, Omaha, NE 68105 | 2011-03-22 |
| 1851537302 | Magda Maria Blanco | Counselor | 1941 South 42nd St Suite 541, Suite 541, Omaha, NE 68105 | 2009-01-05 |
| 1609050848 | James Joseph Shehan | Internal Medicine | 4100 Woolworth, Omaha, NE 68105 | 2007-12-24 |
| 1407051477 | Cristian D Clark | Counselor | 2101 S 42nd Street, Heartland Family Service, Omaha, NE 68105 | 2007-06-19 |
| 1831312305 | Kelli Renae Welvaert | Counselor | 2101 So 42 St, Heartland Family Service, Omaha, NE 68105 | 2007-04-11 |
| Find all providers in zip 68105 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023673282 | Charles Drew Health Center, Inc. | Clinic/Center | 2120 N 30th St Ste 100, Omaha, NE 68111-3701 | 2019-05-03 |
| 1891359485 | Oneworld Community Health Centers Inc | Clinic/Center | 2520 S 130th Ave, Omaha, NE 68144-2527 | 2019-04-29 |
| 1629530373 | Charles Drew Health Center Inc | Clinic/Center | 5190 Sprague Plz Ste 201, Omaha, NE 68104-2891 | 2019-04-02 |
| 1154895225 | Charles Drew Health Center Inc | Clinic/Center | 5319 N 30th St Ste A, Omaha, NE 68111-1604 | 2019-01-11 |
| 1144690074 | Oneworld Community Health Centers, Inc. | Clinic/Center | 4310 S 24th St, Omaha, NE 68107-1805 | 2015-10-05 |
| 1285977660 | Oneworld Community Health Centers, Inc. | Clinic/Center | 4700 Giles Rd, Omaha, NE 68157-2641 | 2013-04-03 |
| 1063725554 | Oneworld Community Health Centers, Inc. | Clinic/Center | 3121 U St, Omaha, NE 68107-3378 | 2010-07-26 |
| 1942513494 | Oneworld Community Health Centers, Inc. | Clinic/Center | 4215 S 20th St, Omaha, NE 68107 | 2010-07-26 |
| 1164735759 | Oneworld Community Health Centers, Inc. | Clinic/Center | 2021 Saint Marys Ave, Omaha, NE 68102-2415 | 2010-07-23 |
| 1801372354 | Oneworld Community Health Centers, Inc. | Clinic/Center | 4920 S 30th St Ste 103, Omaha, NE 68107-1656 | 2018-07-18 |
| 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.