Individual provider Active NPI

Nathan Thomas Shank, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1164940466
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112346 Issued in NE
Practice address
4220 L St
Omaha, NE 68107-1048
Phone
(402) 733-4433
Fax
(402) 733-1220
NPI assigned
Sep 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 73722 NE
Family Nurse Practitioner 363LF0000X 112346 NE Primary

Addresses

Primary practice location

4220 L St
Omaha, NE 68107-1048

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 733-4433

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
I20171020002458 NE Practitioner - Nurse Practitioner 4082980917 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
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

1625 N 205TH St
CHI Health Clinic
Elkhorn, NE 68022-4759
Phone (402) 758-5452

16909 Lakeside Hills CT
Omaha, NE 68130-4661

4220 L St
Suite 100
Omaha, NE 68107-1048
Phone (402) 733-4433

8248 S 96TH St
La Vista, NE 68128-3126
Phone (402) 717-9500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73722NEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Oct 24, 2017 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

3308 Samson Way
Ste 101
Bellevue, NE 68123
Phone (402) 291-3373

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

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

4220 L St
Omaha, NE 68107
Phone (402) 717-7050

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": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1164940466",
    "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": "402-733-4433",
            "fax_number": "402-733-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 L ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071048",
            "telephone_number": "402-733-4433",
            "fax_number": "402-733-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "NATHAN",
        "middle_name": "THOMAS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "73722",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.