NPIMap

Organization Active NPI

Nebraska Advanced Radiology, LLC

  • Radiology Clinic/Center
  • Omaha, NE
National Provider Identifier
1558443028
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
NEBRASKA ADVANCED RADIOLOGY, LLC
Practice address
117 North 32ND Avenue
Suite 100
Omaha, NE 68131-2505
Phone
(402) 715-5200
Fax
(402) 715-5201
NPI assigned
Oct 20, 2006
Last updated
Feb 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Authorized official

Name
Mrs. Robin S Nelson, R.T.(R)(M)(CT)
Title
Manager
Phone
(402) 715-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X IL Primary

Addresses

Primary practice location

117 North 32ND Avenue
Suite 100
Omaha, NE 68131-2505

Mailing address

117 North 32ND Avenue
Suite 100
Omaha, NE 68131-2505
Phone (402) 715-5200

Other identifiers 2

IdentifierTypeStateIssuer
1558448028MedicaidIA
10025469000MedicaidNE

Other names 1

  • Molecular Diagnostics of Eastern Omaha, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

117 N 32nd Ave
Omaha, NE 68131
Phone (402) 715-5200

117 N 32nd Ave
Ste 100
Omaha, NE 68131
Phone (402) 715-5200

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1558443028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 NORTH 32ND AVENUE",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312505",
            "telephone_number": "402-715-5200",
            "fax_number": "402-715-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NORTH 32ND AVENUE",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312505",
            "telephone_number": "402-715-5200",
            "fax_number": "402-715-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA ADVANCED RADIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "402-715-5200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.T.(R)(M)(CT)"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558448028",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025469000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molecular Diagnostics of Eastern Omaha, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 18, 2013; 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.