Individual provider Active NPI

Patrick John Friend, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1477628683
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1164 Issued in NE
Practice address
3525 N 147TH St Ste 205
Omaha, NE 68116-8262
Phone
(402) 491-4087
Fax
(402) 491-4091
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1164 NE Primary

Addresses

Primary practice location

3525 N 147TH St Ste 205
Omaha, NE 68116-8262

Mailing address

3525 N 147TH St Ste 205
Omaha, NE 68116-8262
Phone (402) 491-4087

Other identifiers 2

IdentifierTypeStateIssuer
36607OtherNEBLUE CROSS BLUE SHIELD
47081359900MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000367 NE Practitioner - Chiropractic 7214104900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13808 W Maple Rd
Suite 116
Omaha, NE 68164-6231
Phone (402) 491-4087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1164NEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Run Chiropractic, P.C. CurrentSince Jan 20, 2012 Accepting new patients

Locations

13808 W Maple Rd
Ste 116
Omaha, NE 68164
Phone (402) 491-4087

13808 W Maple Rd
#116
Omaha, NE 68164
Phone (402) 491-4087

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1477628683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 N 147TH ST STE 205",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681168262",
            "telephone_number": "402-491-4087",
            "fax_number": "402-491-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 N 147TH ST STE 205",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681168262",
            "telephone_number": "402-491-4087",
            "fax_number": "402-491-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEND",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36607",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47081359900",
            "state": "NE"
        }
    ],
    "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 Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.