Individual provider Active NPI

Kellen L Huston, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Omaha, NE
National Provider Identifier
1134358500
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
29287 Issued in NE
Practice address
16909 Lakeside Hills CT Ste 208
Omaha, NE 68130-4663
Phone
(402) 717-0820
Fax
(402) 717-6061
NPI assigned
Jul 7, 2009
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 43471 IA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 29287 NE Primary

Addresses

Primary practice location

16909 Lakeside Hills CT Ste 208
Omaha, NE 68130-4663

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 717-0820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160614002438 IA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8527359900 Reassigns benefits to 1 organization
I20160616002242 NE Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8527359900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

7710 Mercy Rd
Suite 2000
Omaha, NE 68124-2323
Phone (402) 717-0820

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43471IAMDSports Medicine (Orthopaedic Surgery) Physician
29287NEMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jan 1, 2020 Accepting new patients
Clarinda Regional Health Center CurrentSince Feb 1, 2018 Accepting new patients
Alegent Creighton Clinic PastSince Jan 1, 2020 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330

1213 Garfield Ave
Harlan, IA 51537
Phone (712) 755-4316

2771 Solution Ctr
Chicago, IL 60677

16909 Lakeside Hills Ct
Ste 208
Omaha, NE 68130
Phone (402) 717-0820

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

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

7710 Mercy Rd
Ste 2000
Omaha, NE 68124
Phone (402) 717-0820

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1134358500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-717-0820",
            "fax_number": "402-717-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 LAKESIDE HILLS CT STE 208",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304663",
            "telephone_number": "402-717-0820",
            "fax_number": "402-717-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTON",
        "first_name": "KELLEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IA",
            "license": "43471",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NE",
            "license": "29287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.