Individual provider Active NPI

Tiffanie Smith

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1194595579
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113132 Issued in NE
Practice address
6901 N 72ND St
Omaha, NE 68122-1709
Phone
(855) 524-4001
Fax
(402) 572-3206
NPI assigned
Jan 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A177159 IA
Family Nurse Practitioner 363LF0000X 113132 NE Primary

Addresses

Primary practice location

6901 N 72ND St
Omaha, NE 68122-1709

Mailing address

6901 N 72ND St
Omaha, NE 68122-1709
Phone (855) 524-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240205003735 NE Practitioner - Nurse Practitioner 7315380565 Reassigns benefits to 1 organization
I20240617002103 IA Practitioner - Nurse Practitioner 7315380565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

6901 N 72ND St
Omaha, NE 68122-1709
Phone (402) 572-2346

800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone (712) 328-5490

Hospital & facility affiliations

  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
  • Memorial Community Hospital & Health System Hospital, Blair, NE, CCN 281359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113132NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Feb 18, 2024 Accepting new patients
Alegent Creighton Clinic CurrentSince Jun 1, 2024 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

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 2

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1194595579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221709",
            "telephone_number": "855-524-4001",
            "fax_number": "402-572-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221709",
            "telephone_number": "855-524-4001",
            "fax_number": "402-572-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIFFANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A177159",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "113132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.