Pride Health Clinic LLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

Legal business name

PRIDE HEALTH CLINIC LLC

Doing business as

Pride Care For All LLC

Practice address

4905 S 107TH Ave # 100
Omaha, NE 68127-1965

Phone

(402) 243-1526

Fax

(877) 684-6190

NPI assigned

Nov 10, 2022

Organization subpart

No

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

Authorized official

Name

Leslie Dvorak, APRNNPI 1265422562

Title

Owner

Phone

(505) 850-2544

Specialties & licenses 1

Addresses

Other names 1

• Pride Care For All LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• LLB Laser LLC

  • Women's Health Nurse Practitioner
  • Omaha, NE
  • NPI 1922847011
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie Irene Dvorak, APRN

  • Women's Health Nurse Practitioner
  • Omaha, NE
  • NPI 1265422562
  Medicare reassignment Care Compare group Authorized official
• Sarah Davis, APRN

  • Family Nurse Practitioner
  • Omaha, NE
  • NPI 1578309019
  Medicare reassignment Care Compare group NPD
• Emily Jordan Blanchard, DNP-WHNP, MPH

  • Women's Health Nurse Practitioner
  • Omaha, NE
  • NPI 1659058360
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1184332918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 LEAWOOD ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464227",
            "telephone_number": "505-850-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 S 107TH AVE # 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271965",
            "telephone_number": "402-243-1526",
            "fax_number": "877-684-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7435 Leawood St",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680464227",
            "country_code": "US",
            "telephone_number": "505-850-2544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIDE HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "DVORAK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-850-2544",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Care For All LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pride Care For All LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanijah Price
• Melissa Prickett, APRN
• Wesley R Prickett, M.D.
• Courtney Prickette
• Richard Priddy
• Kimberly Sue Priebe
• Karin T. Priefert, D.O.
• Kassandra Prieto-Garcia
• Joshua Priluck, M.D.
• Primary Care Physicians, LLP

• Women's Health Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Women's Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.