NPIMap

Organization Active NPI

Alegent Health Clinic

  • Surgery Physician
  • Council Bluffs, IA
National Provider Identifier
1467569848
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ALEGENT HEALTH CLINIC
Doing business as
Alegent Health General Surgery
Practice address
800 Mercy Dr
Suite 220
Council Bluffs, IA 51503-3128
Phone
(712) 328-2660
Fax
(712) 388-2665
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Wayne A Sensor
Title
Chief Executive Officer
Phone
(402) 343-4310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

800 Mercy Dr
Suite 220
Council Bluffs, IA 51503-3128

Mailing address

PO Box 642117
Omaha, NE 68164-8117
Phone (402) 717-4377

Other names 1

  • Alegent Health General Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Brentwoo3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467569848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117",
            "telephone_number": "402-717-4377",
            "fax_number": "402-717-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "address_2": "SUITE 220",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "712-328-2660",
            "fax_number": "712-388-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SENSOR",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "402-343-4310",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alegent Health General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.