Faith Regional Health Services
Organization Active NPI Emergency Medicine Physician · Norfolk, NE
NPI 1104854199 · NPPES record last updated May 18, 2026
Key facts
- NPI
- 1104854199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- FAITH REGIONAL HEALTH SERVICES
- Practice address
- 2700 W Norfolk Ave
Norfolk, NE 68701-4438 - Phone
- (402) 371-4880
- Fax
- (402) 644-7432
- NPI assigned
- Jun 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- FAITH REGIONAL HEALTH SERVICES
Authorized official
- Name
- Kelly A Driscoll
- Title
- President/Ceo
- Phone
- (402) 371-4880
Parent organization (reported in NPPES) 1
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 5
Practitioners 38
-
Kiley Cameron, MD
-
Thomas Scott Diesing, M.D.
-
Michael Pichler, MD
-
John C. Chinault, M.D.
-
Daniel J Ferraro, M.D., PHD
-
Nicolle Marie Moore, NP-C
-
Ari Mosenkis, MD
-
Kelly-Ann Andrea Patrice, M.D.
-
Haley Phillips, M.D.
-
Kevin T White, MD
-
Rena Beth Zimmerman, M.D.
-
Randy D Sorum, M.D.
-
Punya Hari Dahal, M.D.
-
Douglas Arthur Dilly, M.D.
-
Myles Gart, MD
-
Ojbindra KC, MD
-
Brian Jay Keegan, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Niobrara Valley Hospital |
Hospital | Operational/Managerial Control | Apr 1, 2011 |
| Niobrara Valley Hospital |
Hospital | Operational/Managerial Control | Apr 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000464 | NE | Part B Supplier - Clinic/Group Practice | 8921902966 |
Receives reassigned benefits from 38 practitioners Practice locations: Omaha, NE; Norfolk, NE; Gretna, NE; Elkhorn, NE |
National Provider Directory
- Part of
- Faith Regional HLTH SRVC
Locations
110 N 29th St
Ste 101
Norfolk, NE 68701
Phone (402) 644-7534
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Social Worker |
104100000X | |||
| Registered Dietitian |
133V00000X | |||
| Diabetes Educator Registered Nurse |
163WD0400X | |||
| Lactation Consultant (Registered Nurse) |
163WL0100X | |||
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Psychiatry Physician |
2084P0800X | |||
| Hospitalist Physician |
208M00000X | |||
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Physician Assistant |
363A00000X | |||
| Surgical Physician Assistant |
363AS0400X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
2700 W Norfolk Ave
Norfolk, NE 68701-4438
Mailing address
PO Box 869
Norfolk, NE 68702-0869
Phone (402) 644-7249
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31338 | Other | NE | BCBS ER GROUP |
| 10025533600 | Medicaid | NE | |
| 36887 | Other | NE | BCBS DME |
| 0544858 | Medicaid | IA | |
| 10025533500 | Medicaid | NE | |
| 81002 | Other | NE | ZWIENER ONLY |
| 0538280 | Medicaid | IA |
Other names
- FAITH HEALTH PROFESSIONAL SERVICES
- FRHS Professional Services
Other providers in Norfolk, NE
- Martina Eyer
- Jeanna Faesser
- Olouwatobi Yeriel Fagbohoun
- Rabih C Fahed
- Faith Regional Health Services
- Faith Regional Health Services
- Faith Regional Health Services
- Faith Regional Health Services
- Faith Regional Health Services
- Faith Regional Health Services
All providers in Norfolk, NE · Emergency 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 May 18, 2026. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.