Alegent Health Quick Care LLC
Organization Active NPI Family Medicine Physician · Omaha, NE
NPI 1215066568 · NPPES record last updated Apr 3, 2018
Key facts
- NPI
- 1215066568
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ALEGENT HEALTH QUICK CARE LLC
- Practice address
- 3410 N 156TH St
Omaha, NE 68116-2020 - Phone
- (888) 333-7520
- Fax
- (402) 614-5733
- NPI assigned
- Mar 4, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- CHI NEBRASKA
Authorized official
- Name
- Keith Jankuski
- Title
- Coo
- Phone
- (402) 343-4409
Member of 1
Practitioners 13
-
Jessica Lynne Palmer, DNP, FNP-BC
-
Joshua M Endelicato, PA-C
-
Shelly A Hajny, PA
-
Ray Everett Skelton, PA-C
-
Reina C Griffith, APRN
-
Markie Novotny, APRN
-
Darcy M Jones, PA-C
-
Jolene Marie Lies, PA-C
-
Nishavini Ranpatabendi, PA-C
-
Sydney R Williams, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070403000169 | NE | Part B Supplier - Clinic/Group Practice | 3476657370 |
Receives reassigned benefits from 13 practitioners Practice locations: Omaha, NE |
National Provider Directory
Locations
6433 Solution Ctr
Chicago, IL 60677
5010 O St
Lincoln, NE 68510
Phone (402) 314-6704
9717 Q St
Omaha, NE 68127
Phone (402) 537-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
3410 N 156TH St
Omaha, NE 68116-2020
Mailing address
7261 Mercy Rd
Attn: Credentialing
Omaha, NE 68124-2311
Phone (402) 398-6255
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- Alegent Health Partners
- Dulce Alejandrez
- Coleton Hamzeh Alejandro
- Doroo Alewobui
- Alex Machuca Counseling LLC
- Brandon R Alex
All providers in Omaha, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.