Individual provider Active NPI

Nicole M Privitera, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1144746322
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112312 Issued in NE
Practice address
6901 N 72ND St
Omaha, NE 68122-1709
Phone
(855) 524-4001
Fax
(402) 572-3206
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 112312 NE Primary

Addresses

Primary practice location

6901 N 72ND St
Omaha, NE 68122-1709

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6255

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824001527 NE Practitioner - Nurse Practitioner 1658643747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Community Hospital CorporationGroup PAC ID 0749190775, 27 clinicians

Practice addresses (Care Compare)

810 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-2182

812 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-4611

Hospital & facility affiliations

  • Memorial Community Hospital & Health System Hospital, Blair, NE, CCN 281359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Community Hospital Corporation CurrentSince May 1, 2022 Accepting new patients
Memorial Community Hospital Corporation CurrentSince May 1, 2022 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

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.

Hospital & facility affiliations 1

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": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1144746322",
    "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": "14023986255",
            "fax_number": "402-829-8513"
        },
        {
            "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": "PRIVITERA",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.