NPIMap

Organization Active NPI

Nebraska Orthopaedic Hospital LLC

  • Emergency Medicine Physician
  • Omaha, NE
National Provider Identifier
1407087489
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
NEBRASKA ORTHOPAEDIC HOSPITAL LLC
Practice address
2727 S 144TH St
Omaha, NE 68144-5225
Phone
(402) 637-0608
Fax
(402) 637-0645
NPI assigned
Aug 7, 2009
Last updated
Jan 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NEBRASKA ORTHOPAEDIC HOSPITAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Tara L Wisdom
Title
Cfo
Phone
(402) 609-1002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Rheumatology Physician 207RR0500X NU

Addresses

Primary practice location

2727 S 144TH St
Omaha, NE 68144-5225

Mailing address

2808 S 143Rd PLZ
Omaha, NE 68144-5611
Phone (402) 637-0608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091104000007 NE Part B Supplier - Clinic/Group Practice 5395645279 Receives reassigned benefits from 18 practitioners
Practice locations: Omaha, NE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Nebraska Orthopaedic Hospital LLC3 organizations share this tax ID, including this one
Part of
Nebraska Orthopaedic Hospital LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2727 S 144th St
Ste 150
Omaha, NE 68144
Phone (402) 609-1500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1407087489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 S 143RD PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445611",
            "telephone_number": "402-637-0608",
            "fax_number": "402-637-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 S 144TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445225",
            "telephone_number": "402-637-0608",
            "fax_number": "402-637-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA ORTHOPAEDIC HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEBRASKA ORTHOPAEDIC HOSPITAL LLC",
        "enumeration_date": "2009-08-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-609-1002"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.