Robert William Lundholm, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

111311 Issued in NE

Practice address

6910 Pacific Street
Suite 100
Omaha, NE 68106-1044

Phone

(402) 504-3707

Fax

(402) 504-3714

NPI assigned

Oct 24, 2011

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Geode Health of the Midwest LLCGroup PAC ID 8022504406, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Geode Health of the Midwest LLC

  • Psychiatry Physician
  • Lincoln, NE
  • NPI 1285511170
  Medicare reassignment Care Compare group NPD
• Mary Jo Hanigan M.D., P.C.

  • Psychiatry Physician
  • Omaha, NE
  • NPI 1770801789
  Medicare reassignment
• Robert Lundholm Aprn, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
  • NPI 1033588215
  Authorized official Same address or phone
• Human Service Agency

  • Addiction (Substance Use Disorder) Counselor
  • Watertown, SD
  • NPI 1720074644
  NPD (past)

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1356627244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC STREET",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061044",
            "telephone_number": "402-504-3707",
            "fax_number": "402-504-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC STREET",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061044",
            "telephone_number": "402-504-3707",
            "fax_number": "402-504-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDHOLM",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "111311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lundeen
• Luanne M Lundergard, N.P.
• John Lundgren, DDS
• Scott William Lundgren, DO
• Shea Malloy Lundgren
• Sarah Rachelle Lundin, D.O.
• Diana R Lundquist, PA-C
• Judith Robertson Lundquist, LPC
• Terri Lundstedt
• Brexton Kay Lundstrom

• Psychiatric/Mental Health Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.