Individual provider Active NPI

Richard G Runge, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Omaha, NE
National Provider Identifier
1104888775
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
18346 Issued in IA
Practice address
4955 F Street
Omaha, NE 68117
Phone
(402) 717-2871
Fax
(402) 717-5231
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 13210 NE
Cytopathology Physician 207ZC0500X 18346 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 13210 NE
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 18346 IA Primary

Addresses

Primary practice location

4955 F Street
Omaha, NE 68117

Mailing address

PO Box 4907
Omaha, NE 68104
Phone (800) 831-2402

Other identifiers 2

IdentifierTypeStateIssuer
220022264OtherNERR MEDICARE
06376OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101012000984 NE Practitioner - Pathology 7416149216 Reassigns benefits to 1 organization
I20101012001048 IA Practitioner - Pathology 7416149216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18346IAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Mar 1, 2015 Accepting new patients
Alegent Creighton Clinic Current Accepting new patients
Alegent Creighton Clinic CurrentSince Mar 1, 2015 Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

4955 F St
Omaha, NE 68117
Phone (402) 717-2871

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1104888775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4907",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68104",
            "telephone_number": "800-831-2402",
            "fax_number": "843-569-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 F STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68117",
            "telephone_number": "402-717-2871",
            "fax_number": "402-717-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNGE",
        "first_name": "RICHARD",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NE",
            "license": "13210",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IA",
            "license": "18346",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "13210",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "18346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220022264",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06376",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.