NPIMap

Individual provider Active NPI

Keri E Dillon, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1093196909
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
111813 Issued in NE
Practice address
12728 Augusta Ave
Omaha, NE 68144-3754
Phone
(402) 330-1410
Fax
(402) 330-4294
NPI assigned
Jun 16, 2015
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 111813 NE Primary

Addresses

Primary practice location

12728 Augusta Ave
Omaha, NE 68144-3754

Mailing address

12728 Augusta Ave
Omaha, NE 68144-3754
Phone (402) 330-1410

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
I20150706001093 NE Practitioner - Nurse Practitioner 4284946294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Creighton University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Physicians LLPGroup PAC ID 3779548839, 6 clinicians

Practice addresses (Care Compare)

12728 Augusta Ave
Omaha, NE 68144-3754
Phone (402) 330-1410

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Diseases Associates PC CurrentSince Oct 15, 2019 Accepting new patients
Primary Care Physicians, LLP CurrentSince Jun 24, 2015 Accepting new patients

Locations

12728 Augusta Ave
Omaha, NE 68144
Phone (402) 330-1410

8301 Dodge St
Omaha, NE 68114
Phone (402) 354-7071

9202 W Dodge Rd
Ste 203
Omaha, NE 68114
Phone (402) 934-6504

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/49ec4064-7609-4f62-b5e6-20a05e00549b/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/948ddc3f-5cc9-41d2-8d7f-5b15b32755b8/
  • Direct secure messaging: keri.dillon@primarycarephysicians.cernerdirect.com

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 7

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1093196909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 AUGUSTA AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443754",
            "telephone_number": "402-330-1410",
            "fax_number": "402-330-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 AUGUSTA AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443754",
            "telephone_number": "402-330-1410",
            "fax_number": "402-330-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "KERI",
        "middle_name": "E",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NE",
            "license": "111813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.