Individual provider Active NPI

Peggy Vannortwick, LIMHP LMHP LADC

  • Professional Counselor
  • Omaha, NE
National Provider Identifier
1114239472
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
996 Issued in NE
Practice address
12020 Shamrock Plaza
Omaha, NE 68028
Phone
(402) 639-0952
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 996 NE Primary

Addresses

Primary practice location

12020 Shamrock Plaza
Omaha, NE 68028

Mailing address

12020 Shamrock PLZ
Ste 100
Omaha, NE 68154-3537
Phone (402) 639-0952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213002015 NE Practitioner - Mental Health Counselor 6800245085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

7101 Newport Ave
Omaha, NE 68152-2164
Phone (402) 572-2905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients
Alegent Creighton Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

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

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1114239472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 SHAMROCK PLZ",
            "address_2": "STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543537",
            "telephone_number": "402-639-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 SHAMROCK PLAZA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68028",
            "telephone_number": "402-639-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNORTWICK",
        "first_name": "PEGGY",
        "credential": "LIMHP LMHP LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.