NPIMap

Organization Active NPI

Alegent Health Quick Care LLC

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1215066568
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 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
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CHI NEBRASKAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Keith Jankuski
Title
Coo
Phone
(402) 343-4409

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070403000169 NE Part B Supplier - Clinic/Group Practice 3476657370 Receives reassigned benefits from 13 practitioners
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6433 Solution Ctr
Chicago, IL 60677

840 E 23rd St
Fremont, NE 68025
Phone (402) 727-0536

10808 Fort St
Omaha, NE 68164
Phone (402) 493-2089

14591 Stoney Brook Blvd
Omaha, NE 68137
Phone (402) 697-0811

5005 S 153rd St
Omaha, NE 68137
Phone (402) 717-9100

9707 Q St
Omaha, NE 68127
Phone (402) 339-3047

9717 Q St
Omaha, NE 68127
Phone (402) 537-1700

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1215066568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "address_2": "ATTN: CREDENTIALING",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 N 156TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162020",
            "telephone_number": "888-333-7520",
            "fax_number": "402-614-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH QUICK CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHI NEBRASKA",
        "enumeration_date": "2007-03-04",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "JANKUSKI",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "402-343-4409"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.