NPIMap

Organization Active NPI

Alegent Creighton Clinic

Doing business as Alegent Health Clinic - Creighton Medical Associates - RR

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1699035931
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALEGENT CREIGHTON CLINIC
Doing business as
Alegent Health Clinic - Creighton Medical Associates - RR
Practice address
12809 W Dodge Rd
Omaha, NE 68154-2155
Phone
(402) 343-4328
Fax
(402) 343-4389
NPI assigned
May 21, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Authorized official

Name
Maureen A Cavanaugh
Title
Compliance Officer
Phone
(402) 343-4328

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

12809 W Dodge Rd
Omaha, NE 68154-2155

Mailing address

12809 W Dodge Rd
Omaha, NE 68154-2155
Phone (402) 343-4328

Other names 1

  • Alegent Health Clinic - Creighton Medical Associates - RR Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mission Hills Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1699035931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12809 W DODGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542155",
            "telephone_number": "402-343-4328",
            "fax_number": "402-343-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12809 W DODGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542155",
            "telephone_number": "402-343-4328",
            "fax_number": "402-343-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT CREIGHTON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "CAVANAUGH",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "402-343-4328"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alegent Health Clinic - Creighton Medical Associates - RR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 24, 2012; 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.