Kellen O'Neill Walsh, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

33586 Issued in NE

Practice address

16909 Q St
Omaha, NE 68135-1521

Phone

(402) 955-7575

Fax

(402) 955-7555

NPI assigned

Apr 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Children'S Physicians

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1750443503
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1548766926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351521",
            "telephone_number": "402-955-7575",
            "fax_number": "402-955-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351521",
            "telephone_number": "402-955-7575",
            "fax_number": "402-955-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KELLEN",
        "middle_name": "O'NEILL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "33586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Patrick Walsh, M.D.
• Elisabeth Walsh
• Erin C Walsh, PA-C
• Jordan Anne Walsh, MD
• Julie R Walsh, PA-C
• M Robin Walsh
• Marissa Walsh, MD
• Mary Walsh
• Megan Leeann Walsh, MD
• Melynda Stout Walsh

• Pediatrics Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.