NPIMap

Organization Active NPI

Professional Services of Creighton University Medical Center, LLC

  • Dietary Manager
  • Omaha, NE
National Provider Identifier
1669608147
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dietary ManagerTaxonomy code 132700000X
Legal business name
PROFESSIONAL SERVICES OF CREIGHTON UNIVERSITY MEDICAL CENTER, LLC
Practice address
601 N 30TH St
Omaha, NE 68131-2137
Phone
(402) 449-5371
Fax
(402) 449-5020
NPI assigned
Jun 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Mr. Timothy Adams
Title
SVP Regional Operations, Tenet
Phone
(469) 893-2563

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dietary ManagerGroup: 193200000X MULTI-SPECIALTY GROUP 132700000X Primary
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X

Addresses

Primary practice location

601 N 30TH St
Omaha, NE 68131-2137

Mailing address

601 N 30TH St
Omaha, NE 68131-2137
Phone (402) 449-5371

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1669608147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-5371",
            "fax_number": "402-449-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-5371",
            "fax_number": "402-449-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SERVICES OF CREIGHTON UNIVERSITY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SVP REGIONAL OPERATIONS, TENET",
        "authorized_official_telephone_number": "469-893-2563",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietary Manager",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.