Individual provider Active NPI

Emalie Petersen, RN

  • Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1275983678
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112056 Issued in NE
Practice address
555 S 70TH St
Lincoln, NE 68510-2462
Phone
(402) 219-8747
Fax
(402) 219-8748
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 74319 NE
Nurse Practitioner 363L00000X 112056 NE Primary

Addresses

Primary practice location

555 S 70TH St
Lincoln, NE 68510-2462

Mailing address

555 S 70TH St
Lincoln, NE 68510-2462
Phone (402) 219-8747

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
I20160805000372 NE Practitioner - Nurse Practitioner 3678867132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Physician Associates, LLCGroup PAC ID 2365334364, 76 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 475-1011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
74319NEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physician Associates, LLC CurrentSince Nov 24, 2021 Accepting new patients

Locations

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

1600 S 48th St
Ste 600
Lincoln, NE 68506
Phone (402) 416-9327

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Organizations & group practices 1

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 3

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1275983678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102462",
            "telephone_number": "402-219-8747",
            "fax_number": "402-219-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102462",
            "telephone_number": "402-219-8747",
            "fax_number": "402-219-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "EMALIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "74319",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.