Individual provider Active NPI

Priscilla Soth Lacroix, DO

  • Pediatrics Physician
  • Gretna, NE
National Provider Identifier
1134583024
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2024 Issued in NE
Practice address
11946 Standing Stone Dr
Gretna, NE 68028-8094
Phone
(402) 815-4500
Fax
(402) 815-4510
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 2024 NE Primary

Addresses

Primary practice location

11946 Standing Stone Dr
Gretna, NE 68028-8094

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other names 1

  • Priscilla Soth Hor Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191102000150 NE Practitioner - Pediatric Medicine 8729310206 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Pediatrics CurrentSince Nov 30, 2019 Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Alegent Creighton Health Past Accepting new patients

Locations

11946 Standing Stone Dr
Gretna, NE 68028
Phone (402) 815-4500

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
#3
Omaha, NE 68118

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1134583024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11946 STANDING STONE DR",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680288094",
            "telephone_number": "402-815-4500",
            "fax_number": "402-815-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACROIX",
        "first_name": "PRISCILLA",
        "middle_name": "SOTH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "2024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "HOR",
            "middle_name": "SOTH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.