Individual provider Active NPI

Taylor Kalin Stowater, PA

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1548937816
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2677 Issued in NE
Practice address
7710 Mercy Rd Ste 2000
Omaha, NE 68124-2323
Phone
(402) 717-0820
Fax
(402) 829-8513
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2677 NE Primary

Addresses

Primary practice location

7710 Mercy Rd Ste 2000
Omaha, NE 68124-2323

Mailing address

1415 Cuming St Apt 209
Omaha, NE 68102-4726
Phone (402) 833-8191

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
I20211028000710 NE Practitioner - Physician Assistant 8022406842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

16909 Lakeside Hills CT
Omaha, NE 68130-4661

7500 Mercy Rd
Omaha, NE 68124-2319
Phone (402) 398-5580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Nov 1, 2021 Accepting new patients
Alegent Creighton Clinic CurrentSince Nov 1, 2021 Accepting new patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7710 Mercy Rd
Ste 2000
Omaha, NE 68124
Phone (402) 717-0820

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1548937816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 CUMING ST APT 209",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681024726",
            "telephone_number": "402-833-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 2000",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242323",
            "telephone_number": "402-717-0820",
            "fax_number": "402-829-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWATER",
        "first_name": "TAYLOR",
        "middle_name": "KALIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.