NPIMap

Organization Active NPI

MD West One, PC

  • Durable Medical Equipment & Medical Supplies
  • Elkhorn, NE
National Provider Identifier
1295448744
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MD WEST ONE, PC
Practice address
222 N 192ND Street
Elkhorn, NE 68022-2811
Phone
(402) 390-4111
Fax
(402) 391-1533
NPI assigned
Dec 29, 2022
Last updated
Dec 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Jennifer Maureen Fredricks
Title
Business Office Supervisor
Phone
(402) 361-5260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

222 N 192ND Street
Elkhorn, NE 68022-2811

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

National Provider Directory

National Provider Directory
Tax ID family
Midwest Neurosurgery9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 N 192nd St
Elkhorn, NE 68022

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1295448744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-399-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 192ND STREET",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222811",
            "telephone_number": "402-390-4111",
            "fax_number": "402-391-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD WEST ONE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "FREDRICKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MAUREEN",
        "authorized_official_title_or_position": "BUSINESS OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "402-361-5260"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.