Individual provider Active NPI

Elizabeth Anne Dolan, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1417724295
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
85484 Issued in NE
Practice address
13917 Gold Cir
Omaha, NE 68144-2359
Phone
(402) 991-9630
NPI assigned
Dec 11, 2023
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 85484 NE Primary

Addresses

Primary practice location

13917 Gold Cir
Omaha, NE 68144-2359

Mailing address

3110 S 104TH St
Omaha, NE 68124-2504
Phone (480) 651-5765

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
I20240422000743 NE Practitioner - Nurse Practitioner 5991144198 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ven Whole Healthcare LLCGroup PAC ID 9234521980, 6 clinicians

Practice addresses (Care Compare)

13917 Gold Cir
Omaha, NE 68144-2359
Phone (402) 991-9630

7655 Archer PL
Lincoln, NE 68516-5286
Phone (402) 413-9770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85484NEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gatlin Psychiatric Services LLC Psychiatric/Mental Health CurrentSince Jan 2, 2026 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince Feb 19, 2024 Accepting new patients
Ven Whole Healthcare LLC CurrentSince Nov 27, 2024 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince Feb 19, 2024 Accepting new patients

Locations

1919 S 40th St
Ste 111
Lincoln, NE 68506
Phone (402) 224-6884

3201 Pioneers Blvd
Ste 206
Lincoln, NE 68502
Phone (402) 224-6884

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1417724295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 S 104TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242504",
            "telephone_number": "480-651-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13917 GOLD CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442359",
            "telephone_number": "402-991-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "85484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.