ALEGENT HEALTH IMMANUEL MEDICAL CENTER (NPI# 1992964100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992964100 |
| Entity Type | Organization |
| Organization Name | ALEGENT HEALTH IMMANUEL MEDICAL CENTER |
| Other Organization Name | ALEGENT HEALTH IMMANUEL MEDICAL CENTER RTC |
| Practice Address |
6845 N 68th Plaza Omaha NE 68122 |
| Mailing Address |
Po Box 34640 Omaha NE 68134-0640 |
| Practice Telephone | 4025722291 |
| Mailing Telephone | 4027177865 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |
| Authorized Official Name | MAUREEN A. CAVANAUGH (COMPLIANCE OFFICER) |
| Authorized Official Telephone | 4023434328 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Alegent Health Immanuel Medical Center RTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154406643 | Alegent Health Immanuel Medical Center | Skilled Nursing Facility | 6809 N 68th Plz, Omaha, NE 68152-2117 | 2006-10-25 |
| 1306137260 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Suite 2200, Omaha, NE 68122-1709 | 2011-04-27 |
| 1801129838 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Omaha, NE 68122-1709 | 2009-09-09 |
| 1427283795 | Alegent Health Immanuel Medical Center | Psychiatric Unit | 6901 N 72nd St, Omaha, NE 68122-1709 | 2009-05-15 |
| 1912192907 | Alegent Health Immanuel Medical Center | Radiology | 6901 N 72nd St, Omaha, NE 68122-1709 | 2007-09-12 |
| 1497891543 | Alegent Health Immanuel Medical Center | Clinical Neuropsychologist | 6901 N 72nd St, Omaha, NE 68122-1709 | 2007-01-29 |
| 1326126509 | Alegent Health Immanuel Medical Center | Psychiatric Unit | 6901 N 72nd St, Omaha, NE 68122-1709 | 2006-11-02 |
| 1912085184 | Alegent Health Immanuel Medical Center | Clinic/Center | 6901 N 72nd St, Omaha, NE 68122-1709 | 2006-11-02 |
| 1669550844 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Attn Administrator, Omaha, NE 68122-1709 | 2006-11-02 |
| 1760567010 | Alegent Health Immanuel Medical Center | Neurological Surgery | 6901 N 72nd St, Omaha, NE 68122-1709 | 2006-10-26 |
| Street Address |
6845 N 68TH PLAZA |
| City | OMAHA |
| State | NE |
| Zip Code | 68122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609282920 | Andre Jordan | Registered Nurse | 7215 N. 90th Street, Omaha, NE 68122 | 2014-07-08 |
| 1063748895 | Amy Kristine Jones | Speech-Language Pathologist | 703 Country View Dr, Champaign, IL 68122 | 2009-10-29 |
| 1093835852 | Suzane Lynne Bohlen | Nurse Anesthetist, Certified Registered | 6901 N 72 St, Omaha, NE 68122 | 2007-03-29 |
| 1376686733 | Midwest Surgical Associates PC | Surgery | 6828 N 72 St, #5500, Omaha, NE 68122 | 2007-02-15 |
| 1902975386 | Midwest Medical Imaging Center Inc | Radiology | Midwest Medical Imaging Center, 6901 North 72nd Street, Omaha, NE 68122 | 2006-11-07 |
| 1245348754 | Scott Denman Wilt | Anesthesiology | 6901 N 72 Street, Omaha, NE 68122 | 2006-08-25 |
| 1982620639 | Robert J Zadalis | Surgery | 6829 N 72nd St Ste 5500, Omaha, NE 68122 | 2006-07-14 |
| 1245299304 | Kristin Nicole Krobot | Physician Assistant | 6901 N. 72nd St., Immanuel Emergency Room, Omaha, NE 68122 | 2006-03-18 |
| 1326575440 | Kathleen L Koeppel | Registered Nurse | 6901 N 72nd Street, Attn: Diabetic Education, Omaha, NE 68122 | 2017-05-19 |
| 1477008571 | Rabie Emsalem | Internal Medicine | 6901 N 72nd St, Omaha, NE 68122 | 2016-08-18 |
| Find all providers in zip 68122 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326124397 | Cooper Village | Psychiatric Residential Treatment Facility | 8502 Mormon Bridge Rd, Omaha, NE 68152-2150 | 2006-10-31 |
| 1457437717 | Uta Halee Girls Village | Psychiatric Residential Treatment Facility | 10625 Calhoun Rd, Omaha, NE 68112-2034 | 2006-10-30 |
| 1922468230 | Omaha Vamc | Psychiatric Residential Treatment Facility | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2016-02-29 |
| 1194037424 | Telecare Corporation | Psychiatric Residential Treatment Facility | 819 Dorcas St, Omaha, NE 68108-1137 | 2010-07-01 |
| 1962581207 | Uta Halee Girls Village | Psychiatric Residential Treatment Facility | 10625 Calhoun Rd, Omaha, NE 68112-2034 | 2006-11-06 |
| 1578632733 | Cooper Village | Psychiatric Residential Treatment Facility | 8502 Mormon Bridge Rd, Omaha, NE 68152-2150 | 2006-11-06 |
| 1487723649 | Cooper Village | Psychiatric Residential Treatment Facility | 8502 Mormon Bridge Rd, Omaha, NE 68152-2150 | 2006-11-06 |
| 1710064969 | Uta Halee Girls Village | Psychiatric Residential Treatment Facility | 10625 Calhoun Rd, Omaha, NE 68112-2034 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942413091 | I Believe In Me Ranch | Psychiatric Residential Treatment Facility | 21252 Antelope Rd, Pleasanton, NE 68866-3023 | 2007-05-07 |
| 1578603833 | Hopespoke | Psychiatric Residential Treatment Facility | 904 Sumner, Lincoln, NE 68502 | 2007-02-07 |
| 1659392454 | Winnebago Indian Health Service | Psychiatric Residential Treatment Facility | Hwy 77/75, Winnebago, NE 68071 | 2006-07-21 |
| 1962427781 | Epworth Village, Inc. | Psychiatric Residential Treatment Facility | 2119 N Division Ave, York, NE 68467-1009 | 2006-07-13 |
| 1942240122 | State of Nebraska Dept of Admin Services | Psychiatric Residential Treatment Facility | West Prospector Place & Folsom Street, Lincoln, NE 68509-4949 | 2006-06-07 |
| 1891338661 | Mission Field LLC | Psychiatric Residential Treatment Facility | 1104 3rd Ave, Nebraska City, NE 68410-2011 | 2019-10-23 |
| 1528310133 | Epworth Village | Psychiatric Residential Treatment Facility | 2119 N Division Ave, York, NE 68467-1009 | 2012-10-05 |
| 1568531879 | Alegent Health | Psychiatric Residential Treatment Facility | 11111 S 84th St, Papillion, NE 68046-4122 | 2006-11-08 |
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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.