Individual provider Active NPI

Alan W. Wilson, D.O.

  • Emergency Medicine Physician
  • Omaha, NE
National Provider Identifier
1306295977
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7656 Issued in NE
Practice address
8303 Dodge St
Omaha, NE 68114-4108
Phone
(402) 354-4424
Fax
(402) 354-4435
NPI assigned
Jun 6, 2016
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 7656 NE Primary

Addresses

Primary practice location

8303 Dodge St
Omaha, NE 68114-4108

Mailing address

PO Box 2797
Omaha, NE 68103-2797
Phone (402) 354-4230

Other identifiers 2

IdentifierTypeStateIssuer
47037660412MedicaidNE
1306295977MedicaidIA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516002947 NE Practitioner - Emergency Medicine 0840585998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-4540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care of Omaha Maple LLC Current Accepting new patients
Medifast Urgent Care LLC CurrentSince Feb 18, 2024 Accepting new patients
Nebraska Methodist Hospital Emergency Medicine CurrentSince Jun 30, 2019 Accepting new patients

Locations

3830 N 167th Ct
Omaha, NE 68116
Phone (402) 502-2290

727 N 120th St
Omaha, NE 68154
Phone (402) 493-2100

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

8303 Dodge St
Ste LL6
Omaha, NE 68114
Phone (402) 354-4104

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1306295977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797",
            "telephone_number": "402-354-4230",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-4424",
            "fax_number": "402-354-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "7656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660412",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306295977",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.