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Organization Active NPI

Alegent Health Bergan Mercy Health System

Doing business as Alegent Health Lasting Hope Recovery Center Professional Services

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1184897647
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Doing business as
Alegent Health Lasting Hope Recovery Center Professional Services
Practice address
415 S 25TH St
Omaha, NE 68131-3654
Phone
(402) 717-5300
NPI assigned
Apr 7, 2008
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Evert Kuiper
Title
Ceo
Phone
(402) 343-4420

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Clinical Nurse Specialist 364S00000X NU
Family Medicine Physician 207Q00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

415 S 25TH St
Omaha, NE 68131-3654

Mailing address

PO Box 641130
Omaha, NE 68164-7130
Phone (404) 717-4277

Other names 1

  • Alegent Health Lasting Hope Recovery Center Professional Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012000940 NE Part B Supplier - Clinic/Group Practice 8224947783 Receives reassigned benefits from 14 practitioners
Practice locations: Omaha, NE

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Bergan Mercy15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CHI Health Creighton University Medical Center - Bergan MercyOmaha, NE, CCN 280060 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 59

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.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1184897647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641130",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647130",
            "telephone_number": "404-717-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 25TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313654",
            "telephone_number": "402-717-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alegent Health Lasting Hope Recovery Center Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alegent Health Lasting Hope Recovery Center Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.