Individual provider Active NPI

Sina J Linman, APRN

  • Pediatric Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1609946243
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
052795 Issued in IA
Practice address
1 Edmundson PL
Council Bluffs, IA 51503
Phone
(712) 396-4310
Fax
(712) 396-4180
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 052795 IA Primary

Addresses

Primary practice location

1 Edmundson PL
Council Bluffs, IA 51503

Mailing address

3135 W Broadway
Council Bluffs, IA 51501-3359
Phone (712) 328-9100

Other practice location 1

1 Edmundson Pl
Council Bluffs, IA 51503-4658
Phone (712) 396-4310

Other identifiers 1

IdentifierTypeStateIssuer
1609946243MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100202000857 IA Practitioner - Nurse Practitioner 0446393284 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
052795IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Jun 10, 2018 Accepting new patients
Alegent Creighton Clinic CurrentSince Jun 10, 2018 Accepting new patients

Locations

3135 W Broadway
Council Bluffs, IA 51501
Phone (712) 242-2040

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

801 Harmony St
Ste 302
Council Bluffs, IA 51503
Phone (712) 328-2609

2771 Solution Ctr
Chicago, IL 60677

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1609946243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013359",
            "telephone_number": "712-328-9100",
            "fax_number": "402-328-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51503",
            "telephone_number": "712-396-4310",
            "fax_number": "712-396-4180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Edmundson Pl",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515034658",
            "country_code": "US",
            "telephone_number": "712-396-4310",
            "fax_number": "712-396-4180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINMAN",
        "first_name": "SINA",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "052795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609946243",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.