Individual provider Active NPI

Shaylee Ann Laursen, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1609514819
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114176 Issued in NE
Practice address
4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone
(402) 734-4110
Fax
(402) 734-3990
NPI assigned
May 26, 2022
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 114176 NE Primary

Addresses

Primary practice location

4920 S 30TH St Ste 103
Omaha, NE 68107-1656

Mailing address

4920 S 30TH St Ste 103
Omaha, NE 68107-1656
Phone (402) 734-4110

Other practice location 1

3121 U St
Omaha, NE 68107-3378
Phone (402) 933-4968

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
I20220706001922 NE Practitioner - Nurse Practitioner 9739569948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2723 Q St
Omaha, NE 68107-3408
Phone (402) 913-2400

3121 U St
Omaha, NE 68107-3378
Phone (402) 933-4968

4215 S 20TH St
Omaha, NE 68107-2018
Phone (402) 932-7014

4310 S 24TH St
Omaha, NE 68107-1805
Phone (402) 502-8880

4910 S 30TH St
Suite 103
Omaha, NE 68107-1519
Phone (402) 734-4110

4920 S 30TH St
Suite 103
Omaha, NE 68107-1656
Phone (402) 734-4110

4930 S 30TH St
Omaha, NE 68107-1521
Phone (402) 734-4110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114176NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oneworld Community Health Centers, Inc. PastSince Jun 20, 2022 Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients
Oneworld Community Health Centers, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shaylee.laursen.p1@direct.oneworldomaha.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1609514819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3121 U St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681073378",
            "country_code": "US",
            "telephone_number": "402-933-4968",
            "fax_number": "402-933-4988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURSEN",
        "first_name": "SHAYLEE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "114176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.