Traci Marie Fahrenholz

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

45626 Issued in NE

Practice address

320 N 19TH St
Ord, NE 68862-1351

Phone

(308) 728-5013

NPI assigned

Mar 25, 2019

Last updated

Mar 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SCH Dist City of Ord

  dba Ord Public Schools

  • Local Education Agency (LEA)
  • Ord, NE
  • NPI 1265189559
  NPD (past)

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1295295103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N 19TH ST",
            "city": "ORD",
            "state": "NE",
            "postal_code": "688621351",
            "telephone_number": "308-728-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N 19TH ST",
            "city": "ORD",
            "state": "NE",
            "postal_code": "688621351",
            "telephone_number": "308-728-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENHOLZ",
        "first_name": "TRACI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "45626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88-0005",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarson@ordps.org",
            "affiliation": "N",
            "address_1": "320 N 19th St",
            "city": "Ord",
            "state": "NE",
            "country_code": "US",
            "postal_code": "688621351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorsey Eyecare PC
• Mindy K Dorsey, O.D.
• Jerene Faye Drake
• Jennifer S Dugan
• Kristen A Dunbar, PA
• Family Resources of Greater Nebraska, P.C.
• David Wayne Farrar, PA-C
• Lynda Sue Felton
• Vanessa Marie Ference
• Victoria Kristine Ference

• Registered Nurse in Ord, NE
• Providers in Ord, NE by specialty
• Registered Nurse in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.