Individual provider Active NPI

Nicole Wanda Catherine Nolan, MD

  • Radiation Oncology Physician
  • Kearney, NE
National Provider Identifier
1083901698
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
29066 Issued in NE
Practice address
CHI Cancer Center 104 W 33Rd Street
Kearney, NE 68847
Phone
(308) 865-7985
NPI assigned
Jul 3, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Radiation Oncology
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI Health Clinic Specialty LLC (317 clinicians)

Practice addresses (Care Compare)

10 E 31St St
CHI Health Good Samaritan
Kearney, NE 68847-2908
Phone (308) 865-7100

Hospital & facility affiliations

  • CHI Health Good Samaritan Hospital · Kearney, NE · CCN 280009
  • The Nebraska Medical Center Hospital · Omaha, NE · CCN 280013
  • Kearney Regional Medical Center Hospital · Kearney, NE · CCN 280134
  • CHI Health St. Francis Hospital · Grand Island, NE · CCN 280023
  • Kearney County Health Services Hospital Hospital · Minden, NE · CCN 281306

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160721000031 NE Practitioner - Radiation Oncology 6800027566 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43227IAMDRadiation Oncology Physician
57.023749OHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC Radiation Oncology Current
since Jan 17, 2023
Accepting new patients
The Physician Network Past
since Sep 1, 2011
Accepting new patients

Locations

104 W 33rd St
Kearney, NE 68847
Phone (308) 865-7564

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 43227 IA
Radiation Oncology Physician 2085R0001X 57.023749 OH
Radiation Oncology Physician 2085R0001X 29066 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

CHI Cancer Center 104 W 33Rd Street
Kearney, NE 68847

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
10026181000MedicaidNE
1083901698MedicaidIA
10026527500MedicaidNE
10025044300MedicaidNE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 13, 2023.

{
    "created_epoch": "1309651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1083901698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-216-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHI CANCER CENTER 104 W 33RD STREET",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68847",
            "telephone_number": "308-865-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "NICOLE",
        "middle_name": "WANDA CATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-03",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IA",
            "license": "43227",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "57.023749",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NE",
            "license": "29066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026181000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083901698",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026527500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025044300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.