Individual provider Active NPI

Nicole Lea Keedy, APRN

  • Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1194255612
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112277 Issued in NE
Practice address
1600 S 48TH St
Lincoln, NE 68506
Phone
(402) 481-8566
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 112277 NE Primary

Addresses

Primary practice location

1600 S 48TH St
Lincoln, NE 68506

Mailing address

640 W Broadview Dr
Lincoln, NE 68505-2666
Phone (402) 669-3502

Other names 1

  • Nicole Lea Molczyk 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
I20170807002026 NE Practitioner - Nurse Practitioner 1052682267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Specialties PCGroup PAC ID 5991696775, 51 clinicians

Practice addresses (Care Compare)

4545 R St
Suite 100
Lincoln, NE 68503-3799
Phone (402) 465-4545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112277NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Specialties, P.C. CurrentSince Aug 1, 2022 Accepting new patients
Lincoln Digestive Health Center LLC PastSince Aug 1, 2022 Accepting new patients

Locations

4545 R St
Ste 100
Lincoln, NE 68503
Phone (402) 465-4545

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

3901 Pine Lake Rd
Ste 211
Lincoln, NE 68516
Phone (402) 421-2100

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Interoperability endpoints

  • FHIR API: https://498f20c3-8d5e-4c38-b37b-2e5c29e690f9.gastro.prod.fhir.ema-api.com/fhir/r4/

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 7

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1194255612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W BROADVIEW DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685052666",
            "telephone_number": "402-669-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68506",
            "telephone_number": "402-481-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEDY",
        "first_name": "NICOLE",
        "middle_name": "LEA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MOLCZYK",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.