Alegent Creighton Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ALEGENT CREIGHTON CLINIC

Doing business as

CHI Health Clinic

Practice address

12809 W Dodge Road
Omaha, NE 68154-2155

Phone

(402) 398-6255

Fax

(402) 829-8513

NPI assigned

May 16, 2012

Last updated

Aug 9, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

CHI NEBRASKAAs reported in NPPES

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

Authorized official

Name

Keith Jankuski

Title

Coo

Phone

(402) 343-4374

Specialties & licenses 15

Addresses

Other names 1

• CHI Health Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907

  O20040407001314

  Same enrollment
• Alegent Health Memorial Hospital Schuyler

  dba CHI Health Clinic

  • Family Medicine Physician
  • Schuyler, NE
  • NPI 1780601781

  O20040407001314

  Same enrollment

Locations

Practitioners 203

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lindee Abe

  • Family Nurse Practitioner
  • Omaha, NE
  • NPI 1912378845
  NPD
• Ahmed Salah Ahmed Aboeata

  • Cardiovascular Disease Physician
  • Omaha, NE
  • NPI 1376709808

  Internal Medicine

  NPD
• Hussam Salaheddin Abuissa, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Omaha, NE
  • NPI 1679500862

  Cardiovascular Disease

  NPD
• Imad Alsakaf, M.D.

  • Psychiatry Physician
  • Omaha, NE
  • NPI 1295944783
  NPD
• Jessica Kay Batenhorst, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1285397075
  NPD
• Megan Begley, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1992420509
  NPD
• Casey Dean Beran, MD

  • Orthopaedic Surgery Physician
  • Omaha, NE
  • NPI 1144479957
  NPD
• Karl Andrew Bergmann, M.D.

  • Orthopaedic Trauma Physician
  • Omaha, NE
  • NPI 1447497649

  Family Medicine

  NPD
• Adam J Bierbaum, CRNA

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
  • NPI 1114190162
  NPD
• Nickolas Alan Bockoven, PA-C

  • Vascular Surgery Physician
  • Omaha, NE
  • NPI 1912627555
  NPD
• Kaitlyn Ann Boosalis, MPAS, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1659804292
  NPD
• Mikaela A Bounds, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1639654759
  NPD

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1154680700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12809 W DODGE ROAD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542155",
            "telephone_number": "402-398-6255",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12809 W DODGE ROAD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542155",
            "telephone_number": "402-398-6255",
            "fax_number": "402-829-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT CREIGHTON CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHI NEBRASKA",
        "enumeration_date": "2012-05-16",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "JANKUSKI",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "402-343-4374"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Marie Alder
• Alison M Alderman-Dreher, LICSW
• Hailey M Alderman
• Shonna Aldrich
• Aiku Ale
• Alegent Creighton Clinic (CHI Health Clinic)
• Alegent Creighton Clinic (CHI Health Clinic)
• Alegent Creighton Clinic (CHI Health Clinic)
• Alegent Creighton Clinic (Alegent Health Clinic - Creighton Medical Associates - RR)
• Alegent Creighton Clinic (Alegent Health Clinic - Creighton Medical Associates - CML)

• Internal Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Internal Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.