Individual provider Active NPI

Amanda Corey Yeates

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1366079279
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2923 Issued in NE
Practice address
7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Phone
(402) 280-4675
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2923 NE Primary
Infectious Disease Physician 207RI0200X 9629 NE

Addresses

Primary practice location

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353

Mailing address

1111 W 17TH St
Tulsa, OK 74107-1886

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
I20240910002907 NE Practitioner - Internal Medicine 3577924596 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2923NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Specialty, LLC Infectious Disease CurrentSince Sep 1, 2024 Accepting new patients

Locations

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1366079279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 17TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353",
            "telephone_number": "402-280-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEATES",
        "first_name": "AMANDA",
        "middle_name": "COREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "2923",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NE",
            "license": "9629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.