NPIMap

Individual provider Active NPI

Amy Jackson, A.R.N.P.

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1679623672
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
091673 Issued in IA
Practice address
1010 N 96TH St Ste 200
Omaha, NE 68114-2499
Phone
(402) 343-4328
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 091673 IA Primary

Addresses

Primary practice location

1010 N 96TH St Ste 200
Omaha, NE 68114-2499

Mailing address

518 Lincolnway St
Woodbine, IA 51579-1238
Phone (712) 647-2566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060404000102 IA Practitioner - Nurse Practitioner 9739197674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

518 Lincoln Way
Alegent Creighton Clinic Woodbine
Woodbine, IA 51579-1238
Phone (712) 647-2566

Hospital & facility affiliations

  • Harrison County Public Health Home health agency, Logan, IA, CCN 167046
  • Angels Care Home Health of Iowa Home health agency, Council Bluffs, IA, CCN 167292
  • Generations Hospice Care Inc Hospice, Missouri Valley, IA, CCN 161599
  • CHI Health Missouri Valley Hospital, Missouri Valley, IA, CCN 161309
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
  • Azria Health Rose Vista Nursing home, Woodbine, IA, CCN 165357
  • Azria Health Longview Nursing home, Missouri Valley, IA, CCN 165373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
091673IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Community Memorial Hospital of Missouri Valley, Iowa CurrentSince Dec 5, 2017 Accepting new patients
Alegent Health Community Memorial Hospital of Missouri Valley, Iowa Current Accepting new patients
Alegent Creighton Health Past Accepting new patients

Locations

704 Iowa Ave
Dunlap, IA 51529
Phone (712) 643-2298

809 Elm St
Missouri Vly, IA 51555
Phone (712) 642-2794

631 N 8th St
Mo Valley, IA 51555
Phone (712) 642-2045

Interoperability endpoints

  • Direct secure messaging: ajackson37950@achce.catholichealth.net

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1679623672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 LINCOLNWAY ST",
            "city": "WOODBINE",
            "state": "IA",
            "postal_code": "515791238",
            "telephone_number": "712-647-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 96TH ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142499",
            "telephone_number": "402-343-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMY",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "091673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.