Individual provider Active NPI

Peggy Sue Hobus, APRN

  • Nurse Practitioner
  • Bellevue, NE
National Provider Identifier
1467565036
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A081496 Issued in IA
Practice address
2510 Bellevue Medical Center Dr Ste 145a
Bellevue, NE 68123-1556
Phone
(402) 779-7207
Fax
(402) 779-7210
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 A081496 IA Primary

Addresses

Primary practice location

2510 Bellevue Medical Center Dr Ste 145a
Bellevue, NE 68123-1556

Mailing address

302 N Chestnut St
PO Box 342
Avoca, IA 51521-5142
Phone (402) 680-9564

Other identifiers 4

IdentifierTypeStateIssuer
02063OtherIAWELLMARK
10025347100MedicaidNE
1475152MedicaidIA
247897OtherIAMIDLANDS CHOICE

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
I20160609001850 NE Practitioner - Nurse Practitioner 0143245969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A081496IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecare Family Medicine of Bellevue, P.C. Nurse Practitioner CurrentSince Aug 28, 2017 Accepting new patients

Locations

2510 Bellevue Medical Center Dr
Ste 145A
Bellevue, NE 68123
Phone (402) 779-7207

4102 Woolworth Ave
Omaha, NE 68105
Phone (402) 444-7000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1467565036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N CHESTNUT ST",
            "address_2": "PO BOX 342",
            "city": "AVOCA",
            "state": "IA",
            "postal_code": "515215142",
            "telephone_number": "402-680-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BELLEVUE MEDICAL CENTER DR STE 145A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231556",
            "telephone_number": "402-779-7207",
            "fax_number": "402-779-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBUS",
        "first_name": "PEGGY",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A081496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "02063",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025347100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1475152",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "247897",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.