Individual provider Active NPI

Phillip Newcomb, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1447940838
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
77580 Issued in NE
Practice address
13616 California St Ste 100
Omaha, NE 68154-5336
Phone
(402) 496-0404
Fax
(402) 496-7766
NPI assigned
May 10, 2023
Last updated
May 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 77580 NE Primary

Addresses

Primary practice location

13616 California St Ste 100
Omaha, NE 68154-5336

Mailing address

13616 California St Ste 100
Omaha, NE 68154-5336
Phone (402) 496-0404

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
I20230711003153 NE Practitioner - Nurse Practitioner 9335508183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nebraska Spine Center, LLPGroup PAC ID 9830080613, 35 clinicians

Practice addresses (Care Compare)

13616 California St
Suite 100
Omaha, NE 68154-5336
Phone (402) 496-5517

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77580NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Spine Center, LLP CurrentSince Jun 26, 2023 Accepting new patients

Locations

13616 California St
Ste 100
Omaha, NE 68154
Phone (402) 496-5517

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71581

Organizations & group practices 1

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 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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1447940838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-0404",
            "fax_number": "402-496-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-0404",
            "fax_number": "402-496-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "PHILLIP",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "77580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.