Active NPI
Marjorie R Shreve, M.D.
- Family Medicine Physician
- Omaha, NE
National Provider Identifier
1548290471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21276
- Practice address
- 304 N 168TH Cir
#211
Omaha, NE 68118-4091 - Phone
- (402) 289-9325
- Fax
- (402) 289-9829
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21276 | NE | Primary |
Addresses
Primary practice location
304 N 168TH Cir
#211
Omaha, NE 68118-4091
Mailing address
4242 Farnam St
#150
Omaha, NE 68131-2806
Phone (402) 552-6747
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025310200 | Medicaid | NE | |
| 0596700 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1548290471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4242 FARNAM ST",
"address_2": "#150",
"city": "OMAHA",
"state": "NE",
"postal_code": "681312806",
"telephone_number": "402-552-6747",
"fax_number": "402-552-6741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 N 168TH CIR",
"address_2": "#211",
"city": "OMAHA",
"state": "NE",
"postal_code": "681184091",
"telephone_number": "402-289-9325",
"fax_number": "402-289-9829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREVE",
"first_name": "MARJORIE",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "21276",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025310200",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0596700",
"state": "IA"
}
],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.