Individual provider Active NPI

Nicole M Anthony, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1114408531
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112598 Issued in NE
Practice address
6901 N 72ND St
Omaha, NE 68122-1709
Phone
(855) 524-4001
Fax
(402) 572-3206
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A152803 IA
Family Nurse Practitioner 363LF0000X 112598 NE Primary

Addresses

Primary practice location

6901 N 72ND St
Omaha, NE 68122-1709

Mailing address

6901 N 72ND St
Omaha, NE 68122-1709
Phone (855) 524-4001

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181005000905 NE Practitioner - Nurse Practitioner 7113279910 Reassigns benefits to 1 organization
I20181015000803 IA Practitioner - Nurse Practitioner 7113279910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

6901 N 72ND St
Suite 3300
Omaha, NE 68122-1752
Phone (402) 398-5880

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (712) 328-5490

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Sep 3, 2018 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 3, 2018 Accepting new patients

Locations

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

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

2771 Solution Ctr
Chicago, IL 60677

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

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

6901 N 72nd St
Ste 3300
Omaha, NE 68122
Phone (402) 398-5880

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

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.

Hospital & facility affiliations 5

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1114408531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221709",
            "telephone_number": "855-524-4001",
            "fax_number": "402-572-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221709",
            "telephone_number": "855-524-4001",
            "fax_number": "402-572-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A152803",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.