Alegent Creighton Clinic
Organization Active NPI Internal Medicine Physician · Omaha, NE
NPI 1154680700 · NPPES record last updated Aug 9, 2016
Key facts
- NPI
- 1154680700
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ALEGENT CREIGHTON CLINIC
- Practice address
- 12809 W Dodge Road
Omaha, NE 68154-2155 - Phone
- (402) 398-6255
- Fax
- (402) 829-8513
- NPI assigned
- May 16, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- CHI NEBRASKA
Authorized official
- Name
- Keith Jankuski
- Title
- Coo
- Phone
- (402) 343-4374
Other NPIs on the same Medicare enrollment 2
Practitioners 203
-
Imad Alsakaf, M.D.
-
Jessica Kay Batenhorst, PA-C
-
Megan Begley, PA-C
-
Casey Dean Beran, MD
-
Karl Andrew Bergmann, M.D.
-
Adam J Bierbaum, CRNA
-
Nickolas Alan Bockoven, PA-C
-
Kaitlyn Ann Boosalis, MPAS, PA-C
-
Mikaela A Bounds, PA-C
-
Mackenzie C Boyer, PA-C
-
Courtney Brackin, PA-C
-
Megan Elizabeth Brandt, PA-C
-
Angelika Ann Bull, PA-C
-
Khalil John Burhan, M.D.
-
Andrew Chida, PA-C
-
Morgan R Chipps, PA-C
-
Mary Couture, P.A.
-
Rachel Elizabeth Cushing, PHYSICIAN ASSISTANT
-
Kristina Ann Dada, PA-C
-
Rachel Deatz, PA-C
-
Zachary Scott Depew, M.D.
-
Pooja A Deshmukh, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040407001314 | NE | Part B Supplier - Clinic/Group Practice | 1951210418 |
Receives reassigned benefits from 1,202 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
3135 W Broadway
Ste 100
Council Bluffs, IA 51501
Phone (712) 242-2040
3308 Samson Way
Ste 102
Bellevue, NE 68123
Phone (402) 291-3373
5000 N 26th St
Ste 100
Lincoln, NE 68521
Phone (402) 435-5300
4501 S 70th St
Ste 130
Lincoln, NE 68516
Phone (402) 484-4940
7001 A St
Ste 200
Lincoln, NE 68510
Phone (402) 484-3199
1601 N 86th St
Ste 100
Lincoln, NE 68505
Phone (402) 327-7500
2412 Cuming St
Ste 200
Omaha, NE 68131
Phone (402) 717-0380
6360 John J Pershing Dr
Omaha, NE 68110
7710 Mercy Rd
Ste 224
Omaha, NE 68124
Phone (402) 399-8550
10828 John Galt Blvd
Omaha, NE 68137
Phone (402) 592-4400
13315 W Center Rd
Ste 100
Omaha, NE 68144
Phone (402) 717-9400
1109 S 180th St
Omaha, NE 68130
Phone (402) 502-6888
2301 N 117th Ave
Ste 110
Omaha, NE 68164
4220 L St
#100
Omaha, NE 68107
Phone (402) 733-4433
6829 N 72nd St
Ste 3100
Omaha, NE 68122
Phone (402) 391-3870
16909 Lakeside Hills Ct
Ste 101
Omaha, NE 68130
Phone (402) 398-5880
6663 Sorensen Pkwy
Omaha, NE 68152
Phone (402) 453-6869
8613 N 30th St
Omaha, NE 68112
Phone (402) 451-2125
16909 Lakeside Hills Ct
Ste 30
Omaha, NE 68130
7710 Mercy Rd
Ste 2000
Omaha, NE 68124
Phone (402) 717-0820
11109 S 84th St
Ste 5800
Papillion, NE 68046
Phone (402) 827-1577
104 W 17th St
Schuyler, NE 68661
Phone (402) 352-2441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician |
207K00000X | |||
| Anesthesiology Physician |
207L00000X | |||
| Dermatology Physician |
207N00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Hematology & Oncology Physician |
207RH0003X | |||
| Infectious Disease Physician |
207RI0200X | |||
| Nephrology Physician |
207RN0300X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Rheumatology Physician |
207RR0500X | |||
| Anatomic Pathology Physician |
207ZP0101X | |||
| Pediatrics Physician |
208000000X |
Addresses
Primary practice location
12809 W Dodge Road
Omaha, NE 68154-2155
Mailing address
12809 W Dodge Road
Omaha, NE 68154-2155
Phone (402) 398-6255
Other names
- CHI Health Clinic
Other providers in Omaha, NE
- Amanda Marie Alder
- Alison M Alderman-Dreher
- Hailey M Alderman
- Shonna Aldrich
- Aiku Ale
- Alegent Creighton Clinic
- Alegent Creighton Clinic
- Alegent Creighton Clinic
- Alegent Creighton Clinic
- Alegent Creighton Clinic
All providers in Omaha, NE · Internal Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.