Individual provider Active NPI

Cora Villagomez

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1356604193
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111359 Issued in NE
Practice address
7101 Newport Ave
Suite 304
Omaha, NE 68152-2164
Phone
(402) 572-2333
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111359 NE Primary

Addresses

Primary practice location

7101 Newport Ave
Suite 304
Omaha, NE 68152-2164

Mailing address

8871 Kimball St
Omaha, NE 68122-5211
Phone (402) 707-3605

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000561 NE Practitioner - Nurse Practitioner 1153572318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

104 W 17TH St
Schuyler, NE 68661-1304
Phone (402) 352-2441

Hospital & facility affiliations

  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Immanuel Medical Center CurrentSince Sep 1, 2012 Accepting new patients
Alegent Health Immanuel Medical Center CurrentSince Sep 1, 2012 Accepting new patients
Alegent Health Immanuel Medical Center Current Accepting new patients

Locations

16909 Lakeside Hills Ct
Ste 400
Omaha, NE 68130
Phone (402) 758-5850

7101 Newport Ave
Ste 304
Omaha, NE 68152
Phone (402) 572-2333

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

7101 Newport Ave
Omaha, NE 68152
Phone (402) 572-2905

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

104 W 17th St
Schuyler, NE 68661
Phone (402) 352-2441

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1356604193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8871 KIMBALL ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681225211",
            "telephone_number": "402-707-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 NEWPORT AVE",
            "address_2": "SUITE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681522164",
            "telephone_number": "402-572-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ",
        "first_name": "CORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.