NPIMap

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
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 3

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

Addresses

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

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

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 4789098443, 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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
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 CurrentSince Jan 17, 2023 Accepting new patients
The Physician Network PastSince Sep 1, 2011 Accepting new patients

Locations

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

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

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.