Individual provider Active NPI

Kylee Sue Fitch, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1396218996
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112686 Issued in NE
Practice address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone
(402) 609-3000
Fax
(402) 609-3808
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 112686 NE Primary

Addresses

Primary practice location

2725 S 144TH St Ste 212
Omaha, NE 68144-5253

Mailing address

2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 609-3000

Other identifiers 1

IdentifierTypeStateIssuer
112686OtherNEAPRN LICENSE

Other names 1

  • Kylee Sue Douglas Former name

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
I20190129001409 NE Practitioner - Nurse Practitioner 1254678204 Reassigns benefits to 1 organization
I20230911000206 IA Practitioner - Nurse Practitioner 1254678204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthowest, LLCGroup PAC ID 8921086893, 109 clinicians

Practice addresses (Care Compare)

1260 Valley View Dr
Council Bluffs, IA 51503-5245
Phone (402) 609-3000

2725 S 144TH St
Suite 212
Omaha, NE 68144-5253
Phone (402) 609-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest LLC Nurse Practitioner CurrentSince Aug 1, 2023 Accepting new patients
Orthowest LLC Nurse Practitioner CurrentSince Aug 1, 2023 Accepting new patients
Lincoln Digestive Health Center LLC PastSince Jan 7, 2019 Accepting new patients

Locations

933 E Pierce St
Council Bluffs, IA 51503
Phone (712) 328-6000

3415 S 205th St
Elkhorn, NE 68022
Phone (402) 609-1750

2725 S 144th St
Ste 212
Omaha, NE 68144
Phone (402) 354-4000

2725 S 144th St
Ste 110
Omaha, NE 68144
Phone (402) 637-0400

17701 Manderson St
Omaha, NE 68116

7100 W Center Rd
Ste 200
Omaha, NE 68106

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1396218996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "KYLEE",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "112686",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "DOUGLAS",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.