Individual provider Active NPI

Elizabeth Dunklau, APRN

  • Family Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1194117481
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111776 Issued in NE
Practice address
2300 S 16TH St
Lincoln, NE 68502-3704
Phone
(402) 481-5150
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111776 NE Primary

Addresses

Primary practice location

2300 S 16TH St
Lincoln, NE 68502-3704

Mailing address

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 481-5150

Other names 1

  • Elizabeth Rose Nissen Former name

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
I20150515001734 NE Practitioner - Nurse Practitioner 1456671353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Fremont Health CurrentSince Oct 1, 2018 Accepting new patients
Physicians Clinic Inc CurrentSince May 3, 2020 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients

Locations

2540 N Healthy Way
Fremont, NE 68025
Phone (402) 721-3133

680 E Fremont Medical Park Dr
Ste 100
Fremont, NE 68025
Phone (402) 727-5200

450 E 23rd St
Fremont, NE 68025
Phone (402) 721-1610

207 S Engdahl Ave
Oakland, NE 68045
Phone (402) 685-5683

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Interoperability endpoints

  • Direct secure messaging: elizabeth.dunklau.1@14940.direct.athenahealth.com
  • Direct secure messaging: elizabeth.dunklau@direct.nmhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1194117481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 16TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023704",
            "telephone_number": "402-481-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLAU",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "NISSEN",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.