NPIMap

Organization Active NPI

Childrens Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Omaha, NE
National Provider Identifier
1346729886
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
CHILDRENS HOSPITAL & MEDICAL CENTER
Practice address
111 N 84TH St
Omaha, NE 68114
Phone
(402) 955-6826
NPI assigned
Aug 7, 2018
Last updated
Nov 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDRENS HOSPITAL & MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Authorized official

Name
Chanda C Chacon
Title
President & Ceo
Phone
(402) 955-4106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

111 N 84TH St
Omaha, NE 68114

Mailing address

8200 Dodge St
Omaha, NE 68114-4113
Phone (402) 955-6826

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190318001945 NE Part A Provider - End-Stage Renal Disease Facility (ESRD) 3173419355 Practice locations: Omaha, NE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
George E Reynolds MD23 organizations share this tax ID, including this one
Part of
George E Reynolds MD

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Children's Home HealthcareOmaha, NE, CCN 287063 Home health agency Operational/Managerial Control (100%) Dec 29, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1346729886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-6826",
            "fax_number": "402-955-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N 84TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-955-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS HOSPITAL & MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDRENS HOSPITAL & MEDICAL CENTER",
        "enumeration_date": "2018-08-07",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "402-955-4106"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.