Atlas Medical Nebraska LLC
Organization Active NPI Family Medicine Physician · Omaha, NE
NPI 1104666536 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1104666536
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ATLAS MEDICAL NEBRASKA LLC
- Practice address
- 8214 F St Ste C
Omaha, NE 68127-1740 - Phone
- (402) 331-2273
- Fax
- (402) 933-4255
- NPI assigned
- May 31, 2024
- Organization subpart
- No
Authorized official
- Name
- Gregory Mangum, RN
- Title
- Ceo
- Phone
- (435) 514-5646
Practitioners 7
-
Stacie Fiala, OTR/L
-
Angela Mitchell, OTR/L
-
Deanna Leigh Swanson, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241121003051 | NE | Part B Supplier - Clinic/Group Practice | 2769917145 |
Receives reassigned benefits from 2 practitioners Practice locations: Omaha, NE |
National Provider Directory
Locations
8214 F St
Ste C
Omaha, NE 68127
Phone (402) 331-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
8214 F St Ste C
Omaha, NE 68127-1740
Mailing address
8214 F St Ste C
Omaha, NE 68127-1740
Phone (402) 331-2273
Other providers in Omaha, NE
- Koffi Nyuiemedi Ativon
- Tiffany Nichole Atkins
- Amber Jo Atkinson
- Micaela Atkinson
- Leigha Marie Atkisson
- Atlas RX LLC
- Atlas RX LLC
- Funmilayo Atobatele
- Attachment and Trauma Center of Nebraska, LLC
- Attain Health Omaha Medical and Chiropractic, LLC
All providers in Omaha, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.