Active NPI
Mark David Pilley, M.D.
- Family Medicine Physician
- Omaha, NE
National Provider Identifier
1235129057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 15805
- Practice address
- 11043 Prairie Brook Rd
Omaha, NE 68144-4829 - Phone
- (402) 689-6811
- Fax
- (360) 844-6336
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15805 | NE | Primary |
Addresses
Primary practice location
11043 Prairie Brook Rd
Omaha, NE 68144-4829
Mailing address
PO Box 871897
Vancouver, WA 98687-1897
Phone (402) 689-6811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15805 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258502400000",
"number": "1235129057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 871897",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986871897",
"telephone_number": "402-689-6811",
"fax_number": "360-844-6336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11043 PRAIRIE BROOK RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681444829",
"telephone_number": "402-689-6811",
"fax_number": "360-844-6336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILLEY",
"first_name": "MARK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2009-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "15805",
"primary": true
}
],
"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 Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.