Individual provider Active NPI

Susan Elizabeth Lacy

  • Certified Registered Nurse Anesthetist
  • Omaha, NE
National Provider Identifier
1306023544
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901702 Issued in NE
Practice address
601 N 30TH St
Omaha, NE 68131-2137
Phone
(402) 449-4000
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 901702 NE Primary

Addresses

Primary practice location

601 N 30TH St
Omaha, NE 68131-2137

Mailing address

1610 S 35TH St
Omaha, NE 68105-2522
Phone (402) 345-9485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080510000085 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759460157 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 2, 2018 Accepting new patients
Alegent Creighton Clinic CurrentSince Sep 1, 2012 Accepting new patients
Creighton University Past Accepting new patients
Creighton University Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
CHI Health Clinic Specialty, LLC Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

7710 Mercy Rd
Ste 426
Omaha, NE 68124
Phone (402) 343-8650

6901 N 72nd St
Ste 22330
Omaha, NE 68122
Phone (402) 717-4673

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1306023544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 S 35TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052522",
            "telephone_number": "402-345-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "901702",
            "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 Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.