Individual provider Active NPI

Carolyn Sue Schluckebier

  • Gastroenterology Registered Nurse
  • Omaha, NE
National Provider Identifier
1174349880
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology Registered NurseTaxonomy code 163WG0100X
License
498268 Issued in NE
Practice address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone
(402) 995-3668
NPI assigned
Nov 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 498268 NE Primary

Addresses

Primary practice location

4101 Woolworth Ave
Omaha, NE 68105-1850

Mailing address

5102 N 137TH Ave
Omaha, NE 68164-6195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
498268NEMDGastroenterology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1174349880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 N 137TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681646195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-995-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUCKEBIER",
        "first_name": "CAROLYN",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "NE",
            "license": "498268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.