NPIMap

Organization Active NPI

Alegent Creighton Health

Doing business as CHI Health Lakeside

  • General Acute Care Hospital
  • Omaha, NE
National Provider Identifier
1649355132
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H000106 Issued in NE
Legal business name
ALEGENT CREIGHTON HEALTH
Doing business as
CHI Health Lakeside
Practice address
16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone
(402) 717-8000
NPI assigned
Oct 25, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Evert Kuiper
Title
CHI Health Ceo
Phone
(402) 343-4420

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU
General Acute Care Hospital 282N00000X H000106 NE Primary

Addresses

Primary practice location

16901 Lakeside Hills CT
Omaha, NE 68130-2318

Mailing address

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (402) 717-8000

Other identifiers 1

IdentifierTypeStateIssuer
10025144000MedicaidNE

Other names 1

  • CHI Health Lakeside Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000334 NE Part A Provider - Hospital 1850285255 Practice locations: Omaha, NE; Elkhorn, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649355132. Details of each certification follow.

Hospital certification: CCN 280130

Legal name
ALEGENT CREIGHTON HEALTH
Doing business as
CHI HEALTH LAKESIDE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 5, 2004
Last certification
May 9, 2013
Beds
157
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
16901 Lakeside Hills CT
Omaha, NE 68130-2318
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
CHI Health LakesideCCN 280130 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D1024347CHI Health Lakeside Laboratory16901 Lakeside Hills CT, Omaha, NE 68130AccreditationFeb 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Member of 6

Organizations this organization is a member of, according to the National Provider Directory.

Locations

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
CHI Nebraska Organization, Omaha, NE Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Nadine a Heimann Individual Corporate Director Jul 1, 2019
Julie Goebel Individual Corporate DirectorAdvisory Board Member Oct 1, 2025
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
Thomas Rohleder Individual Corporate OfficerSecretary Oct 1, 2025
Corporate DirectorBoard Member Oct 1, 2025
Cindy a Alloway Individual Corporate DirectorDirector Jul 1, 2023
Tim Bricker Individual Corporate OfficerPresident Oct 1, 2025
Corporate DirectorPresident Jul 1, 2023
William Barney Individual Corporate OfficerTreasurer Jul 16, 2020
Corporate DirectorDirector Jul 16, 2020
Kevin Fitzgerald Individual Corporate OfficerSecretary Jul 15, 2021
Corporate DirectorDirector Jul 15, 2021
Nick O'Tool Individual Corporate OfficerChief Financial Officer Jul 1, 2023
Operational/Managerial ControlInterim Cfo - CHI Health Jan 7, 2023
Heather M Morgan Individual Corporate Director Jul 1, 2020
Kirtibala Gupta Individual Corporate DirectorBod Jul 15, 2021
Thomas McGinn Individual Corporate DirectorBoard Member Oct 1, 2025
Michelle Johnson Tidjani Individual Corporate OfficerChief Admin Officer, CSH Oct 1, 2025
Corporate DirectorChief Admin Officer, CSH Oct 1, 2025
Mardell Wilson Individual Corporate Director Oct 15, 2020
Kelly Bacon Individual Corporate DirectorBod Jul 15, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thayer County Health ServicesHebron, NE, CCN 281304 Hospital Operational/Managerial Control Jul 29, 2016
Memorial Community Hospital Health SystemsBlair, NE, CCN 281359 Hospital Other Apr 1, 2002
Memorial Community Hospital & Health SystemBlair, NE, CCN 28Z359 Hospital Other Apr 1, 2002
Nebraska Spine Hospital LLCOmaha, NE, CCN 280133 Hospital 5% Or Greater Direct Ownership Interest (51%) Apr 5, 2010
Thayer County Health ServicesHebron, NE, CCN 28Z304 Hospital Operational/Managerial Control Jul 29, 2016
MCH Physicians; Blair ClinicBlair, NE, CCN 283462 Rural health clinic Other Apr 1, 2002
Davenport Medical ClinicDavenport, NE, CCN 283436 Rural health clinic Operational/Managerial Control Jul 29, 2016
Hebron Medical ClinicHebron, NE, CCN 283434 Rural health clinic Operational/Managerial Control Jul 29, 2016
Deshler Medical ClinicDeshler, NE, CCN 283446 Rural health clinic Operational/Managerial Control Jul 29, 2016
Bruning Medical ClinicBruning, NE, CCN 283433 Rural health clinic Operational/Managerial Control Jul 29, 2016
Cottonwood Rural Health ClinicTekamah, NE, CCN 283404 Rural health clinic Other Apr 1, 2002
Fort Calhoun ClinicFort Calhoun, NE, CCN 288506 Rural health clinic Other Apr 1, 2002

Facilities with the same owner 38

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 38

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

Affiliated clinicians 736

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 736

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1649355132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-717-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 LAKESIDE HILLS CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302318",
            "telephone_number": "402-717-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT CREIGHTON HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CHI HEALTH CEO",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NE",
            "license": "H000106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025144000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health Lakeside",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health Lakeside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.