Colleen E Short, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

110878 Issued in NE

Practice address

3410 N 156TH St
Attn: Quick Care
Omaha, NE 68116-2020

Phone

(800) 253-4368

Fax

(402) 614-5733

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Colleen Blake Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleenshort@thinkaks.allscriptsdirect.net

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.

• Think Aksarben, LLC

  dba Think Whole Person Healthcare

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1316357676
  Medicare reassignment NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1386810489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 N 156TH ST",
            "address_2": "ATTN: QUICK CARE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162020",
            "telephone_number": "800-253-4368",
            "fax_number": "402-614-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "COLLEEN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110878",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NE",
            "license": "110878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "098611197",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "BLAKE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shoptikal LLC (Shopko Optical 4056)
• Shoptikal LLC (Shopko Optical 4044)
• Trason Lyle Shoquist
• Boyd Clifton Short Jr., CHAPLAIN
• Chelese Short
• Dana Short
• Maurice Short
• Akira Shorter
• Katrina Shotswell
• Justine Shoulders

• Primary Care Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Primary Care Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.