Individual provider Active NPI

Kelly Hoover, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1366809923
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1976 Issued in NE
Practice address
825 N 90TH St
Omaha, NE 68114-2702
Phone
(402) 932-2248
NPI assigned
Jan 26, 2016
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1976 NE Primary
Medical Physician Assistant 363AM0700X 1976 NE

Addresses

Primary practice location

825 N 90TH St
Omaha, NE 68114-2702

Mailing address

2808 N 75TH St
Omaha, NE 68134-6861
Phone (402) 932-2248

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
I20160302001716 NE Practitioner - Physician Assistant 6406152313 Reassigns benefits to 1 organization
I20160818000330 IA Practitioner - Physician Assistant 6406152313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nebraska College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ven Healthcare Council Bluffs LLCGroup PAC ID 5496107955, 2 clinicians

Practice addresses (Care Compare)

13917 Gold Cir
Omaha, NE 68144-2359
Phone (402) 991-9630

29 S Main St
Council Bluffs, IA 51503-9070
Phone (712) 524-1888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1976NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince Nov 1, 2022 Accepting new patients
Ven Mental Health and TMS Clinic LLC Physician Assistant PastSince Jul 9, 2025 Accepting new patients
Cord Where Science Meets Connection LLC PastSince Mar 31, 2025 Accepting new patients

Locations

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1366809923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 N 75TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346861",
            "telephone_number": "402-932-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142702",
            "telephone_number": "402-932-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1976",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.