Individual provider Active NPI

Grant Fabry, APRN-NP

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1306527148
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
114889 Issued in NE
Practice address
1111 N 102ND CT Ste 200
Omaha, NE 68114-2194
Phone
(402) 502-2747
Fax
(402) 502-2387
NPI assigned
Jul 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 114889 NE Primary
Gerontology Nurse Practitioner 363LG0600X 114889 NE

Addresses

Primary practice location

1111 N 102ND CT Ste 200
Omaha, NE 68114-2194

Mailing address

1111 N 102ND CT Ste 200
Omaha, NE 68114-2194
Phone (402) 502-2747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230810001951 NE Practitioner - Nurse Practitioner 2668834458 Reassigns benefits to 2 organizations
I20230920001560 IA Practitioner - Nurse Practitioner 2668834458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

1001 Risen Son Blvd
Council Bluffs, IA 51503-1910
Phone (712) 256-8600

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

1111 N 102ND CT
200 MPC Omaha Nephrology
Omaha, NE 68114-2194
Phone (402) 354-9770

16120 W Dodge Rd
Omaha, NE 68118-2049
Phone (402) 354-0550

24110 W Dodge Rd
Methodist Physicians Clinic West Shores
Waterloo, NE 68069-4705
Phone (402) 359-2277

717 N 190TH PLZ
Suite 1100
Elkhorn, NE 68022-3917
Phone (402) 815-1700

808 E Pierce St
Methodist Physicians Clinic
Council Bluffs, IA 51503-4652
Phone (712) 396-4360

8901 W Dodge Rd
Omaha, NE 68114-3327
Phone (402) 390-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114889NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Nephrology PC CurrentSince Aug 28, 2023 Accepting new patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Sep 30, 2025 Accepting new patients

Locations

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

201 Ridge St
Ste 207
Council Bluffs, IA 51503
Phone (712) 388-0261

505 Cornhusker Rd
Ste 107
Bellevue, NE 68005
Phone (402) 292-2813

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

1111 N 102nd Ct
Ste 200
Omaha, NE 68114
Phone (402) 991-6559

Organizations & group practices 2

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 6

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": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1306527148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N 102ND CT STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142194",
            "telephone_number": "402-502-2747",
            "fax_number": "402-502-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRY",
        "first_name": "GRANT",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "114889",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NE",
            "license": "114889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.