Charles J Sprague, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22145 Issued in NE

Practice address

16929 Frances St
Ste 101
Omaha, NE 68130-4683

Phone

(402) 758-5124

Fax

(402) 758-5283

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Father Flanagan'S Boys' Home

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1295821825
  Medicare reassignment NPD
• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  NPD (past)
• Father Flanagan'S Boys Home

  • Psychologist
  • Boys Town, NE
  • NPI 1265405419
  NPD (past)
• Father Flanagan'S Boys' Home

  • Children's Hospital
  • Omaha, NE
  • NPI 1457458556
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1649334913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312136",
            "telephone_number": "402-280-8100",
            "fax_number": "402-280-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16929 FRANCES ST",
            "address_2": "STE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681304683",
            "telephone_number": "402-758-5124",
            "fax_number": "402-758-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "22145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann G Sporkman-Link, MA
• Dea Dea Renae Sporleder
• Veronica Sporleder
• Sydni J Sporven
• Isaac Spotanski
• Ida Rose Sprague
• Rachelle Michelle Sprague, RN
• Danyell Spraling
• Sara Sprecher
• Spring Forward OT, LLC

• Pediatrics Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.