Individual provider Active NPI

Ann Marie Lerdahl

  • Certified Registered Nurse Anesthetist
  • Lincoln, NE
National Provider Identifier
1386661726
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100200 Issued in NE
Practice address
555 S 70TH St
Lincoln, NE 68510-2462
Phone
(402) 434-5600
Fax
(402) 434-5601
NPI assigned
Jul 15, 2006
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 100200 NE Primary

Addresses

Primary practice location

555 S 70TH St
Lincoln, NE 68510-2462

Mailing address

575 S 70TH St Ste 305
Lincoln, NE 68510-2471
Phone (402) 434-5600

Other identifiers 1

IdentifierTypeStateIssuer
47060018715MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1386661726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S 70TH ST STE 305",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102471",
            "telephone_number": "402-434-5600",
            "fax_number": "402-434-5601"
        },
        {
            "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": "402-434-5600",
            "fax_number": "402-434-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERDAHL",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47060018715",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.