Individual provider Active NPI

Kassie A Lueth

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1144746363
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112307 Issued in NE
Practice address
16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone
(855) 524-4001
Fax
(402) 717-7340
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X H149417 IA
Nurse Practitioner 363L00000X 112307 NE Primary

Addresses

Primary practice location

16901 Lakeside Hills CT
Omaha, NE 68130-2318

Mailing address

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (402) 398-6255

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
I20170831001021 NE Practitioner - Nurse Practitioner 0648543355 Reassigns benefits to 1 organization
I20180129000136 IA Practitioner - Nurse Practitioner 0648543355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Creighton University School of Medicine, 2017
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)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

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 Dec 25, 2017 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 17, 2017 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

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

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

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

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 2

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": "1516752000000",
    "number": "1144746363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "14023986255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "855-524-4001",
            "fax_number": "402-717-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETH",
        "first_name": "KASSIE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H149417",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.