Individual provider Active NPI

Carol Ann Havlat, APRN-NP

  • Family Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1639506900
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111566 Issued in NE
Practice address
3901 Pine Lake Rd Ste 120
Lincoln, NE 68516-5497
Phone
(402) 420-1212
Fax
(402) 328-0961
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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 111566 NE Primary

Addresses

Primary practice location

3901 Pine Lake Rd Ste 120
Lincoln, NE 68516-5497

Mailing address

3901 Pine Lake Rd Ste 120
Lincoln, NE 68516-5497
Phone (402) 420-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1639506900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD STE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-420-1212",
            "fax_number": "402-328-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD STE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-420-1212",
            "fax_number": "402-328-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLAT",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.