Individual provider Active NPI

Chanda Lynn Nunnenkamp, FNP-C

  • Family Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1235755182
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113156 Issued in NE
Practice address
2510 S 40TH St Ste 100
Lincoln, NE 68506-2408
Phone
(420) 483-6000
Fax
(402) 483-6106
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 113156 NE Primary

Addresses

Primary practice location

2510 S 40TH St Ste 100
Lincoln, NE 68506-2408

Mailing address

2510 S 40TH St Ste 100
Lincoln, NE 68506-2408
Phone (402) 483-6000

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
I20210610000865 NE Practitioner - Nurse Practitioner 6800296054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

2510 S 40TH St
100 CHI Health Clinic
Lincoln, NE 68506-2408
Phone (402) 483-6000

555 S 70TH St
CHI Health St. Elizabeth
Lincoln, NE 68510-2462
Phone (402) 219-8000

Hospital & facility affiliations

  • CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113156NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jul 1, 2021 Accepting new patients
Ageless Men'S Health Series II NE LLC PastSince Jun 1, 2020 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

2510 S 40th St
Ste 100
Lincoln, NE 68506
Phone (402) 483-6000

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

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

Organizations & group practices 3

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 4

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1235755182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 S 40TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062408",
            "telephone_number": "402-483-6000",
            "fax_number": "402-483-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 S 40TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062408",
            "telephone_number": "420-483-6000",
            "fax_number": "402-483-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNENKAMP",
        "first_name": "CHANDA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "113156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.