Individual provider Active NPI

Claire Christine Fanta

  • Physician Assistant
  • Lincoln, NE
National Provider Identifier
1376264929
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
555 S 70TH St
Lincoln, NE 68510-2462
Phone
(402) 219-7142
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

555 S 70TH St
Lincoln, NE 68510-2462

Mailing address

7150 Holmes Park Rd Apt 307
Lincoln, NE 68506-4685
Phone (402) 358-0734

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
I20230426002164 NE Practitioner - Physician Assistant 5799140794 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2873NEMDOccupational Therapist
118356IAMDHomemaker

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Aug 31, 2023 Accepting new patients
New Century Physicians of Nebraska LLC CurrentSince Apr 1, 2023 Accepting new patients
St. Mary'S Community Hospital CurrentSince Dec 31, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Sep 20, 2023 Accepting new patients
The Physician Network PastSince Sep 1, 2011 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

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

1301 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 713-0110

2412 Cuming St
Omaha, NE 68131
Phone (402) 449-4000

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

Organizations & group practices 6

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": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1376264929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 HOLMES PARK RD APT 307",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064685",
            "telephone_number": "402-358-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102462",
            "telephone_number": "402-219-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTA",
        "first_name": "CLAIRE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.