Omaha Nephrology PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

OMAHA NEPHROLOGY PC

Practice address

1111 N 102ND CT Ste 200
Omaha, NE 68114-2194

Phone

(402) 502-2747

Fax

(402) 502-2387

NPI assigned

Oct 5, 2006

Last updated

Apr 10, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David C Goldner, MDNPI 1356441836

Title

Authorized Official

Phone

(402) 502-2747

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

Enrollment records 2

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christy Marie Baker, APRN-NP

  • Nurse Practitioner
  • Omaha, NE
  • NPI 1457065716

  IA

  Medicare reassignment Care Compare group NPD
• Joseph Patrick Bast Jr., M.D.

  • Nephrology Physician
  • Omaha, NE
  • NPI 1124287131

  IA

  Medicare reassignment Care Compare group NPD
• Judd P Bauer, M.D.

  • Nephrology Physician
  • Omaha, NE
  • NPI 1982833554

  IA

  Medicare reassignment Care Compare group NPD
• Sonali S Deshmukh, MD

  • Nephrology Physician
  • Omaha, NE
  • NPI 1831126259

  IA

  Medicare reassignment Care Compare group NPD
• Sunil Kumar Jagadesh, MD

  • Nephrology Physician
  • Omaha, NE
  • NPI 1932320066

  IA

  Medicare reassignment Care Compare group NPD
• Heather Therese Lechnowsky, MD

  • Nephrology Physician
  • Omaha, NE
  • NPI 1568562064

  IA

  Medicare reassignment Care Compare group NPD
• Richard J Lund, M.D.

  • Nephrology Physician
  • Omaha, NE
  • NPI 1609969468

  IA

  Medicare reassignment Care Compare group NPD
• Audai Ibrahim Ma'Ayah, MD

  • Nephrology Physician
  • Omaha, NE
  • NPI 1538663315

  IA

  Medicare reassignment Care Compare group NPD
• Eric Keoni Magliulo, MD

  • Nephrology Physician
  • Omaha, NE
  • NPI 1336701689

  IA

  Medicare reassignment Care Compare group NPD
• Julia Marie Wageman, APRN

  • Nurse Practitioner
  • Omaha, NE
  • NPI 1326145129

  IA

  Medicare reassignment Care Compare group NPD
• David Charles Goldner, MD

  • Nephrology Physician
  • Aurora, CO
  • NPI 1356441836

  IA, NE

  Medicare reassignment NPD Authorized official
• Grant Fabry, APRN-NP

  • Nurse Practitioner
  • Omaha, NE
  • NPI 1306527148

  IA

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1053407064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAHA NEPHROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "GOLDNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "402-502-2747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD3083",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0993865",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Omaha Nursing Home Inc
• Omaha OBGYN Associates PC
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• Omaha Occupational and Speech Therapy, PC

• Nephrology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Nephrology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.